| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.28 | $481.07 | $8,500.00 | |
Medica
| Facility | $165.28 | $481.07 | $921.80 |
Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.28 | $481.07 | $8,500.00 | |
Medica
| Facility | $165.28 | $481.07 | $921.80 |