| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,352.65 | $1,518.41 | $3,955.04 | |
United
| Facility | $1,069.00 | $2,445.00 | $4,602.00 |
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 | $1,352.65 | $1,518.41 | $3,955.04 | |
United
| Facility | $1,069.00 | $2,445.00 | $4,602.00 |