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 | $1,023.29 | $1,995.26 | $6,456.54 | |
BCBS
| Facility | $5,248.07 | $5,248.07 | $5,248.07 | |
Cigna
| Facility | $4,897.79 | $4,897.79 | $5,370.32 | |
United
| Facility | $977.24 | $4,365.16 | $12,589.25 |