| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $275.76 | $1,070.00 | $2,812.00 | |
BCBS
| Facility | $635.99 | $635.99 | $763.19 | |
United
| Facility | $330.00 | $827.00 | $2,285.00 |
Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $275.76 | $1,070.00 | $2,812.00 | |
BCBS
| Facility | $635.99 | $635.99 | $763.19 | |
United
| Facility | $330.00 | $827.00 | $2,285.00 |