| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $4,466.84 | $4,466.84 | |
Kaiser Permanente
| Professional | $251.19 | $1,174.90 | $1,479.11 | |
United
| Facility | $2,137.96 | $2,137.96 | $2,137.96 |
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 | $1,778.28 | $4,466.84 | $4,466.84 | |
Kaiser Permanente
| Professional | $251.19 | $1,174.90 | $1,479.11 | |
United
| Facility | $2,137.96 | $2,137.96 | $2,137.96 |