| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $609.57 | $2,986.00 | $4,975.00 | |
Kaiser Permanente
| Professional | $1,152.90 | $2,598.30 | $2,598.30 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |
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 | $609.57 | $2,986.00 | $4,975.00 | |
Kaiser Permanente
| Professional | $1,152.90 | $2,598.30 | $2,598.30 | |
United
| Facility | $2,648.00 | $3,378.00 | $26,408.00 |