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Anesthesia For Shock Wave Kidney Stone Treatment

Massachusetts rates for HCPCS 00873

Covers the anesthesia for lithotripsy, a treatment that sends focused shock waves through the skin to break a kidney stone into fragments small enough to pass in the urine. The anesthesia keeps you still and comfortable while the shocks are delivered. The doctor performing the treatment charges separately.

Rates data updated October 2026.

How much rates vary

Facilitymedian $204 · 10th to 90th $30 to $525Professionalmedian $81 · 10th to 90th $32 to $1,445
$20$100$500$2Kfacility $204professional $81

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
$32.36
Median
$416.87
Typical High
$645.65
Aetna
Setting
Professional
Modifier
None
Typical Low
$32.36
Median
$32.36
Typical High
$602.56
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$131.83
Median
$213.80
Typical High
$512.86
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$89.13
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$363.08
Typical High
$588.84
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$21.38
Median
$30.20
Typical High
$5,888.44
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$64.57
Typical High
$112.20
Health New England
Setting
Professional
Modifier
None
Typical Low
$588.84
Median
$724.44
Typical High
$724.44
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$131.83
Median
$213.80
Typical High
$512.86
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$89.13
Typical High
$1,445.44
Tufts
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$208.93
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$64.57
Typical High
$112.20
Well Sense
Setting
Facility
Modifier
None
Typical Low
$131.83
Median
$177.83
Typical High
$275.42
Well Sense
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$144.54