| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,925.65 | $5,244.00 | $8,031.00 | |
Anthem BCBS
| Facility | $8,217.00 | $8,931.00 | $11,908.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |
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 | $1,925.65 | $5,244.00 | $8,031.00 | |
Anthem BCBS
| Facility | $8,217.00 | $8,931.00 | $11,908.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |