| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,285.00 | $14,552.94 | |
Moda Health
| Facility | $310.35 | $1,155.80 | $1,652.79 | |
Providence
| Facility | $310.35 | $1,155.80 | $1,652.79 |
Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,285.00 | $14,552.94 | |
Moda Health
| Facility | $310.35 | $1,155.80 | $1,652.79 | |
Providence
| Facility | $310.35 | $1,155.80 | $1,652.79 |