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Anesthesia For Shock Wave Kidney Stone Treatment

Missouri 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 July 2026.

How much rates vary

Facilitymedian $40 · 10th to 90th $40 to $40
facility $40

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Medica
Setting
Facility
Modifier
QK · Directing 2–4 cases
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Medica
Setting
Facility
Modifier
QX · CRNA, directed
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Medica
Setting
Facility
Modifier
QY · Directing one CRNA
Typical Low
$39.81
Median
$39.81
Typical High
$39.81