| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,775.68 | $3,775.68 | $3,775.68 | |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $1,112.65 | $1,456.30 | $2,598.30 |
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 | $3,775.68 | $3,775.68 | $3,775.68 | |
Cigna
| Facility | $1,745.52 | $1,745.52 | $1,745.52 | |
Kaiser Permanente
| Professional | $1,112.65 | $1,456.30 | $2,598.30 |