| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $317.22 | $390.12 | $8,500.00 | |
Medica
| Facility | $317.22 | $437.03 | $951.66 |
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 |
|---|---|---|---|---|---|
Aetna
| Facility | $317.22 | $390.12 | $8,500.00 | |
Medica
| Facility | $317.22 | $437.03 | $951.66 |