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Pennsylvania rates for HCPCS 00873

Anesthesia for lithotripsy, extracorporeal shock wave; without water bath

Facilitymedian $288 · 10th–90th $229$7940%20%10th90th$288$100.0$200.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
QK
Typical Low / Median / Typical High
$281.84 / $281.84 / $288.40
Aetna
Facility/Professional
Facility
Modifier
QX
Typical Low / Median / Typical High
$630.96 / $776.25 / $794.33
Aetna
Facility/Professional
Facility
Modifier
QY
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Highmark BCBS
Facility/Professional
Facility
Modifier
QZ
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66