| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,513.56 | $3,890.45 | $3,890.45 | |
Kaiser Permanente
| Professional | $239.88 | $1,202.26 | $1,479.11 | |
United
| Facility | $1,995.26 | $1,995.26 | $1,995.26 |
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 | $1,513.56 | $3,890.45 | $3,890.45 | |
Kaiser Permanente
| Professional | $239.88 | $1,202.26 | $1,479.11 | |
United
| Facility | $1,995.26 | $1,995.26 | $1,995.26 |