| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,486.00 | $3,883.00 | $4,705.00 | |
Kaiser Permanente
| Professional | $267.95 | $1,290.83 | $1,642.89 | |
United
| Facility | $1,981.00 | $1,981.00 | $1,981.00 |
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 | $1,486.00 | $3,883.00 | $4,705.00 | |
Kaiser Permanente
| Professional | $267.95 | $1,290.83 | $1,642.89 | |
United
| Facility | $1,981.00 | $1,981.00 | $1,981.00 |