| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $298.98 | $362.55 | $1,400.00 | |
CareSource
| Facility | $332.89 | $369.84 | $402.95 | |
Cigna
| Facility | $533.78 | $533.78 | $533.78 |
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 | $298.98 | $362.55 | $1,400.00 | |
CareSource
| Facility | $332.89 | $369.84 | $402.95 | |
Cigna
| Facility | $533.78 | $533.78 | $533.78 |