| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,700.00 | $5,076.00 | $5,076.00 | |
CareSource
| Facility | $193.69 | $215.21 | $234.47 | |
Cigna
| Facility | $205.96 | $205.96 | $205.96 |
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 | $1,700.00 | $5,076.00 | $5,076.00 | |
CareSource
| Facility | $193.69 | $215.21 | $234.47 | |
Cigna
| Facility | $205.96 | $205.96 | $205.96 |