| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $392.19 | $6,406.52 | $6,529.43 | |
Medica
| Facility | $392.19 | $693.31 | $7,421.86 |
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 | $392.19 | $6,406.52 | $6,529.43 | |
Medica
| Facility | $392.19 | $693.31 | $7,421.86 |