| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,285.00 | $14,552.94 | |
Moda Health
| Facility | $525.46 | $1,957.78 | $2,799.63 | |
Providence
| Facility | $525.46 | $1,957.78 | $2,799.63 |
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,285.00 | $14,552.94 | |
Moda Health
| Facility | $525.46 | $1,957.78 | $2,799.63 | |
Providence
| Facility | $525.46 | $1,957.78 | $2,799.63 |