| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $3,999.00 | $6,456.00 | |
Kaiser Permanente
| Professional | $1,027.21 | $2,323.94 | $2,323.94 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |
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 | $1,017.00 | $3,999.00 | $6,456.00 | |
Kaiser Permanente
| Professional | $1,027.21 | $2,323.94 | $2,323.94 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |