| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,974.75 | $6,653.00 | $9,479.00 | |
Anthem BCBS
| Facility | $8,873.00 | $9,678.00 | $12,904.00 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |
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; new access, without separate nephrostomy catheter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,974.75 | $6,653.00 | $9,479.00 | |
Anthem BCBS
| Facility | $8,873.00 | $9,678.00 | $12,904.00 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |