| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $5,248.07 | $9,549.93 | |
Anthem BCBS
| Facility | $6,456.54 | $11,748.98 | $13,803.84 | |
United
| Facility | $4,570.88 | $7,079.46 | $11,220.18 |
Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $5,248.07 | $9,549.93 | |
Anthem BCBS
| Facility | $6,456.54 | $11,748.98 | $13,803.84 | |
United
| Facility | $4,570.88 | $7,079.46 | $11,220.18 |