| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $1,562.71 | $11,351.00 | |
Anthem BCBS
| Facility | $1,449.90 | $1,611.00 | $3,700.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |
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 | $100.00 | $1,562.71 | $11,351.00 | |
Anthem BCBS
| Facility | $1,449.90 | $1,611.00 | $3,700.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |