| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,607.12 | $10,175.36 | $13,413.92 | |
Moda Health
| Facility | $431.58 | $2,272.37 | $7,986.50 | |
Providence
| Facility | $431.58 | $2,272.37 | $7,986.50 |
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, with separate nephrostomy catheter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,607.12 | $10,175.36 | $13,413.92 | |
Moda Health
| Facility | $431.58 | $2,272.37 | $7,986.50 | |
Providence
| Facility | $431.58 | $2,272.37 | $7,986.50 |