| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.40 | $0.40 | $357.45 | |
Martin's Point
| Facility | $0.40 | $0.40 | $0.40 |
Cysto W/Rescj/Fulg Orthopic Ureterocele Uni/Bi
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.40 | $0.40 | $357.45 | |
Martin's Point
| Facility | $0.40 | $0.40 | $0.40 |