| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $339.67 | $1,596.92 | $3,641.70 | |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $1,127.25 | $1,476.32 | $2,637.22 |
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 | $339.67 | $1,596.92 | $3,641.70 | |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $1,127.25 | $1,476.32 | $2,637.22 |