| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,759.30 | $4,759.30 | $4,759.30 | |
Aetna
| Professional | $4,759.30 | $4,759.30 | $4,759.30 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |
Probe, Robotic, Water-Jet
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,759.30 | $4,759.30 | $4,759.30 | |
Aetna
| Professional | $4,759.30 | $4,759.30 | $4,759.30 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |