| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,216.71 | $2,216.71 | $2,216.71 | |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $989.34 | $1,297.52 | $2,323.94 |
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 | $2,216.71 | $2,216.71 | $2,216.71 | |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $989.34 | $1,297.52 | $2,323.94 |