| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,635.55 | $2,747.00 | $5,484.00 | |
Kaiser Permanente
| Professional | $415.86 | $453.66 | $529.27 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 |
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,635.55 | $2,747.00 | $5,484.00 | |
Kaiser Permanente
| Professional | $415.86 | $453.66 | $529.27 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 |