| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.47 | $3,011.47 | $4,100.00 | |
Kaiser Permanente
| Professional | $1,168.76 | $2,637.22 | $2,637.22 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |
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 | $616.47 | $3,011.47 | $4,100.00 | |
Kaiser Permanente
| Professional | $1,168.76 | $2,637.22 | $2,637.22 | |
United
| Facility | $1,832.00 | $2,343.00 | $26,408.00 |