| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $352.29 | $1,336.89 | $3,804.00 | |
BCBS
| Facility | $3,259.72 | $3,259.72 | $3,911.66 | |
United
| Facility | $980.00 | $1,650.00 | $4,233.00 |
Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $352.29 | $1,336.89 | $3,804.00 | |
BCBS
| Facility | $3,259.72 | $3,259.72 | $3,911.66 | |
United
| Facility | $980.00 | $1,650.00 | $4,233.00 |