| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.89 | $950.00 | $2,825.00 | |
BCBS
| Facility | $826.06 | $826.06 | $976.29 | |
United
| Facility | $482.00 | $870.00 | $3,986.00 |
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 | $412.89 | $950.00 | $2,825.00 | |
BCBS
| Facility | $826.06 | $826.06 | $976.29 | |
United
| Facility | $482.00 | $870.00 | $3,986.00 |