| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,522.00 | $7,629.00 | $10,565.00 | |
Anthem BCBS
| Facility | $8,416.00 | $12,905.00 | $17,206.00 | |
United
| Facility | $6,787.00 | $10,417.00 | $16,323.00 |
Perq Nl/Pl Lithotrp Simple Up To 2 Cm 1 Location
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,522.00 | $7,629.00 | $10,565.00 | |
Anthem BCBS
| Facility | $8,416.00 | $12,905.00 | $17,206.00 | |
United
| Facility | $6,787.00 | $10,417.00 | $16,323.00 |