| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Well Sense
| Facility | 26 | $24.55 | $28.84 | $28.84 |
Dilation of ureter(s) or urethra, radiological supervision and interpretation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Well Sense
| Facility | 26 | $24.55 | $28.84 | $28.84 |