| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,518.41 | $1,543.03 | $3,955.04 | |
United
| Facility | $1,069.00 | $1,788.00 | $4,602.00 |
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 | $1,518.41 | $1,543.03 | $3,955.04 | |
United
| Facility | $1,069.00 | $1,788.00 | $4,602.00 |