| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,265.80 | $6,606.93 | $10,964.78 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $3,467.37 | $7,413.10 | $15,135.61 |
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 | $4,265.80 | $6,606.93 | $10,964.78 | |
Horizon BCBS
| Facility | $7,244.36 | $11,220.18 | $17,378.01 | |
United
| Facility | $3,467.37 | $7,413.10 | $15,135.61 |