| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $432.06 | $5,845.00 | $10,692.00 | |
Horizon BCBS
| Facility | $6,990.20 | $7,684.77 | $17,029.74 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |
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 | $432.06 | $5,845.00 | $10,692.00 | |
Horizon BCBS
| Facility | $6,990.20 | $7,684.77 | $17,029.74 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |