| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $301.49 | $301.49 | $2,300.00 | |
CareSource
| Facility | $337.66 | $375.50 | $409.12 | |
Cigna
| Facility | $361.28 | $361.28 | $361.28 |
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 | $301.49 | $301.49 | $2,300.00 | |
CareSource
| Facility | $337.66 | $375.50 | $409.12 | |
Cigna
| Facility | $361.28 | $361.28 | $361.28 |