| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,898.00 | $3,444.00 | |
Kaiser Permanente
| Professional | $201.31 | $1,038.18 | $1,321.32 | |
United
| Facility | $1,106.00 | $1,106.00 | $1,106.00 |
Convert nephrostomy catheter to 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, via pre-existing nephrostomy tract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,898.00 | $3,444.00 | |
Kaiser Permanente
| Professional | $201.31 | $1,038.18 | $1,321.32 | |
United
| Facility | $1,106.00 | $1,106.00 | $1,106.00 |