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Anesthesia for Shock Wave Treatment of Kidney Stones

Minnesota rates for HCPCS 00872

Anesthesia care during shock wave lithotripsy, in which focused sound waves aimed from outside the body break a kidney stone into fragments small enough to pass in the urine. The anesthesia team keeps the patient still and pain-free while the shocks are delivered and monitors breathing and heart rhythm throughout. The doctor carrying out the treatment charges separately.

Rates data updated October 2026.

How much rates vary

Facilitymedian $35 · 10th to 90th $35 to $437Professionalmedian $71 · 10th to 90th $35 to $251
$50$100$200$500$1Kfacility $35professional $71

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$436.52
Aetna
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$575.44
BCBS Minnesota
Setting
Professional
Modifier
QX · CRNA, directed
Typical Low
$51.29
Median
$72.44
Typical High
$79.43
Cigna
Setting
Professional
Modifier
None
Typical Low
$354.81
Median
$457.09
Typical High
$1,071.52
Medica
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$79.43
Typical High
$162.18
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$75.86
Typical High
$114.82
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Cigna
Setting
Professional
Modifier
AA · Anesthesiologist
Typical Low
$562.34
Median
$707.95
Typical High
$1,047.13
Health Partners
Setting
Professional
Modifier
AA · Anesthesiologist
Typical Low
$426.58
Median
$645.65
Typical High
$1,698.24