| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $891.25 | $4,265.80 | $9,120.11 | |
Medica
| Facility | $239.88 | $1,479.11 | $5,011.87 | |
United
| Facility | $1,862.09 | $2,818.38 | $6,309.57 |
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 | $891.25 | $4,265.80 | $9,120.11 | |
Medica
| Facility | $239.88 | $1,479.11 | $5,011.87 | |
United
| Facility | $1,862.09 | $2,818.38 | $6,309.57 |