| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $645.65 | $7,762.47 | |
Providence
| Facility | $436.52 | $588.84 | $1,202.26 | |
United
| Facility | $645.65 | $6,606.93 | $23,442.29 |
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 | $446.68 | $645.65 | $7,762.47 | |
Providence
| Facility | $436.52 | $588.84 | $1,202.26 | |
United
| Facility | $645.65 | $6,606.93 | $23,442.29 |