| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,137.96 | $4,897.79 | $10,471.29 | |
Anthem BCBS
| Facility | $3,715.35 | $4,168.69 | $12,022.64 | |
United
| Facility | $4,570.88 | $7,079.46 | $11,220.18 |
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 | $2,137.96 | $4,897.79 | $10,471.29 | |
Anthem BCBS
| Facility | $3,715.35 | $4,168.69 | $12,022.64 | |
United
| Facility | $4,570.88 | $7,079.46 | $11,220.18 |