| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,995.31 | $10,175.36 | $13,413.92 | |
Moda Health
| Facility | $336.02 | $1,770.20 | $6,631.90 | |
Providence
| Facility | $336.02 | $1,770.20 | $6,631.90 |
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 | $2,995.31 | $10,175.36 | $13,413.92 | |
Moda Health
| Facility | $336.02 | $1,770.20 | $6,631.90 | |
Providence
| Facility | $336.02 | $1,770.20 | $6,631.90 |