| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.48 | $1,216.94 | $1,700.00 | |
CareSource
| Facility | $357.79 | $396.10 | $431.55 | |
Cigna
| Facility | $573.71 | $573.71 | $573.71 |
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 | $320.48 | $1,216.94 | $1,700.00 | |
CareSource
| Facility | $357.79 | $396.10 | $431.55 | |
Cigna
| Facility | $573.71 | $573.71 | $573.71 |