| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $7,838.38 | $8,763.29 | |
Providence
| Facility | $434.76 | $434.76 | $1,741.26 | |
United
| Facility | $6,602.00 | $9,127.00 | $10,150.00 |
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 | $1,000.00 | $7,838.38 | $8,763.29 | |
Providence
| Facility | $434.76 | $434.76 | $1,741.26 | |
United
| Facility | $6,602.00 | $9,127.00 | $10,150.00 |