| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.48 | $1,010.40 | $1,700.00 | |
CareSource
| Facility | $278.89 | $308.68 | $336.31 | |
Cigna
| Facility | $447.21 | $447.21 | $447.21 |
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 | $248.48 | $1,010.40 | $1,700.00 | |
CareSource
| Facility | $278.89 | $308.68 | $336.31 | |
Cigna
| Facility | $447.21 | $447.21 | $447.21 |