| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,778.87 | $4,519.26 | $4,519.26 | |
United
| Facility | $2,654.00 | $3,447.00 | $7,350.00 |
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 | $2,778.87 | $4,519.26 | $4,519.26 | |
United
| Facility | $2,654.00 | $3,447.00 | $7,350.00 |