| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $2,106.92 | $11,351.00 | |
Anthem BCBS
| Facility | $3,302.10 | $3,669.21 | $6,000.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |
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 | $100.00 | $2,106.92 | $11,351.00 | |
Anthem BCBS
| Facility | $3,302.10 | $3,669.21 | $6,000.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |