| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $3,019.95 | $4,168.69 | |
Kaiser Permanente
| Professional | $1,174.90 | $1,258.93 | $2,630.27 | |
United
| Facility | $2,344.23 | $14,454.40 | $26,302.68 |
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 | $616.60 | $3,019.95 | $4,168.69 | |
Kaiser Permanente
| Professional | $1,174.90 | $1,258.93 | $2,630.27 | |
United
| Facility | $2,344.23 | $14,454.40 | $26,302.68 |