| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.08 | $398.11 | $8,511.38 | |
Medica
| Facility | $398.11 | $575.44 | $1,174.90 | |
United
| Facility | $4,677.35 | $5,128.61 | $5,128.61 |
Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.08 | $398.11 | $8,511.38 | |
Medica
| Facility | $398.11 | $575.44 | $1,174.90 | |
United
| Facility | $4,677.35 | $5,128.61 | $5,128.61 |