| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.11 | $320.11 | $8,500.00 | |
Medica
| Facility | $320.11 | $442.62 | $960.33 |
Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.11 | $320.11 | $8,500.00 | |
Medica
| Facility | $320.11 | $442.62 | $960.33 |