Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, complicated anatomy)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,691.53 | $6,165.95 | $9,772.37 | |
BCBS
| Facility | $1,412.54 | $6,606.93 | $6,918.31 | |
Medica
| Facility | $54.95 | $1,905.46 | $8,511.38 | |
United
| Facility | $1,995.26 | $5,754.40 | $10,471.29 |