| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $654.80 | $3,949.00 | $6,178.10 | |
Highmark BCBS
| Facility | $2,374.03 | $2,374.03 | $2,443.53 |
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 | $654.80 | $3,949.00 | $6,178.10 | |
Highmark BCBS
| Facility | $2,374.03 | $2,374.03 | $2,443.53 |