| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QZ | $769.60 | $769.60 | $769.60 |
Anesthesia for lithotripsy, extracorporeal shock wave; without water bath
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QZ | $769.60 | $769.60 | $769.60 |