| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $612.38 | $2,331.21 | $9,859.00 | |
Anthem BCBS
| Facility | $4,769.10 | $5,299.00 | $8,600.00 | |
United
| Facility | $11,155.00 | $11,155.00 | $11,155.00 |
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 | $612.38 | $2,331.21 | $9,859.00 | |
Anthem BCBS
| Facility | $4,769.10 | $5,299.00 | $8,600.00 | |
United
| Facility | $11,155.00 | $11,155.00 | $11,155.00 |