| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $812.83 | $10,715.19 | $14,125.38 | |
Moda Health
| Facility | $302.00 | $1,258.93 | $4,786.30 | |
Providence
| Facility | $489.78 | $1,778.28 | $6,606.93 |
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; new access, without separate nephrostomy catheter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $812.83 | $10,715.19 | $14,125.38 | |
Moda Health
| Facility | $302.00 | $1,258.93 | $4,786.30 | |
Providence
| Facility | $489.78 | $1,778.28 | $6,606.93 |