| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,168.69 | $6,606.93 | $10,964.78 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $2,951.21 | $6,606.93 | $10,964.78 |
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 | $4,168.69 | $6,606.93 | $10,964.78 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $2,951.21 | $6,606.93 | $10,964.78 |