| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,070.00 | $4,376.00 | $12,154.00 | |
Medica
| Facility | $319.33 | $1,526.28 | $3,899.00 | |
United
| Facility | $1,779.00 | $3,647.00 | $6,988.00 |
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 | $2,070.00 | $4,376.00 | $12,154.00 | |
Medica
| Facility | $319.33 | $1,526.28 | $3,899.00 | |
United
| Facility | $1,779.00 | $3,647.00 | $6,988.00 |