| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,659.03 | $2,659.03 | $2,659.03 | |
Kaiser Permanente
| Professional | $400.90 | $533.20 | $870.07 |
Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $2,659.03 | $2,659.03 | $2,659.03 | |
Kaiser Permanente
| Professional | $400.90 | $533.20 | $870.07 |