| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,774.00 | $14,552.94 | |
Moda Health
| Facility | $589.22 | $2,195.17 | $3,139.09 | |
Providence
| Facility | $589.22 | $2,195.17 | $3,139.09 |
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,236.00 | $9,774.00 | $14,552.94 | |
Moda Health
| Facility | $589.22 | $2,195.17 | $3,139.09 | |
Providence
| Facility | $589.22 | $2,195.17 | $3,139.09 |