| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.00 | $5,402.51 | $9,578.95 | |
Kaiser Permanente
| Professional | $714.05 | $1,560.99 | $1,560.99 | |
United
| Facility | $3,261.00 | $4,165.00 | $26,408.00 |
Perq Nl/Pl Lithotrp Simple Up To 2 Cm 1 Location
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.00 | $5,402.51 | $9,578.95 | |
Kaiser Permanente
| Professional | $714.05 | $1,560.99 | $1,560.99 | |
United
| Facility | $3,261.00 | $4,165.00 | $26,408.00 |