| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $352.09 | $1,314.60 | $1,879.88 | |
Providence
| Facility | $352.09 | $1,314.60 | $1,879.88 |
Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $352.09 | $1,314.60 | $1,879.88 | |
Providence
| Facility | $352.09 | $1,314.60 | $1,879.88 |