| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $602.56 | $741.31 | $1,023.29 | |
Cigna
| Professional | $501.19 | $794.33 | $1,318.26 | |
United
| Professional | $602.56 | $831.76 | $2,398.83 |
Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $602.56 | $741.31 | $1,023.29 | |
Cigna
| Professional | $501.19 | $794.33 | $1,318.26 | |
United
| Professional | $602.56 | $831.76 | $2,398.83 |