go back

Anesthesia For Shock Wave Kidney Stone Treatment

New York 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 $537 · 10th to 90th $42 to $891Professionalmedian $166 · 10th to 90th $44 to $617
$50$100$200$500$1Kfacility $537professional $166

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
$41.69
Median
$575.44
Typical High
$891.25
Aetna
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$41.69
Typical High
$691.83
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$309.03
Median
$478.63
Typical High
$758.58
Cigna
Setting
Facility
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$389.05
Typical High
$707.95
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$109.65
Typical High
$870.96
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$100.00
Typical High
$354.81
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$616.60
Typical High
$741.31
United
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$70.79
Typical High
$120.23
Univera
Setting
Facility
Modifier
None
Typical Low
$102.33
Median
$102.33
Typical High
$218.78
Univera
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$100.00
Typical High
$354.81
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
Ambetter
Setting
Professional
Modifier
QZ · CRNA, independent
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
Highmark BCBS
Setting
Professional
Modifier
AA · Anesthesiologist
Typical Low
$501.19
Median
$707.95
Typical High
$954.99