| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $533.28 | $3,565.64 | $10,013.07 | |
Martin's Point
| Facility | $1,422.15 | $3,565.64 | $10,013.07 |
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 | $533.28 | $3,565.64 | $10,013.07 | |
Martin's Point
| Facility | $1,422.15 | $3,565.64 | $10,013.07 |