| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,137.96 | $5,495.41 | $9,549.93 | |
Anthem BCBS
| Facility | $3,715.35 | $4,168.69 | $12,022.64 | |
United
| Facility | $5,754.40 | $8,709.64 | $11,748.98 |
Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,137.96 | $5,495.41 | $9,549.93 | |
Anthem BCBS
| Facility | $3,715.35 | $4,168.69 | $12,022.64 | |
United
| Facility | $5,754.40 | $8,709.64 | $11,748.98 |