| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.94 | $182.94 | $8,500.00 | |
Medica
| Facility | $182.94 | $255.08 | $548.82 |
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 | $182.94 | $182.94 | $8,500.00 | |
Medica
| Facility | $182.94 | $255.08 | $548.82 |