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Anesthesia for Shock Wave Treatment of Kidney Stones

Wisconsin 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 July 2026.

Facilitymedian $31 · 10th–90th $31$310%50%100%$31

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Quartz
Setting
Facility
Modifier
QK · Directing 2–4 cases
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Quartz
Setting
Facility
Modifier
QX · CRNA, directed
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Quartz
Setting
Facility
Modifier
QY · Directing one CRNA
Typical Low
$30.90
Median
$30.90
Typical High
$30.90