| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $417.24 | $417.24 | $8,500.00 | |
Medica
| Facility | $417.24 | $574.01 | $2,444.00 |
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 | $417.24 | $417.24 | $8,500.00 | |
Medica
| Facility | $417.24 | $574.01 | $2,444.00 |