| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $617.90 | $1,687.91 | $4,478.00 | |
BCBS
| Facility | $3,259.72 | $3,259.72 | $3,911.66 | |
United
| Facility | $1,240.00 | $2,314.00 | $5,652.00 |
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, with separate nephrostomy catheter
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $617.90 | $1,687.91 | $4,478.00 | |
BCBS
| Facility | $3,259.72 | $3,259.72 | $3,911.66 | |
United
| Facility | $1,240.00 | $2,314.00 | $5,652.00 |