| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11,011.45 | $11,011.45 | $16,515.45 | |
Martin's Point
| Facility | $11,011.45 | $11,011.45 | $16,515.45 |
Perq Nl/Pl Lithotrp Simple Up To 2 Cm 1 Location
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11,011.45 | $11,011.45 | $16,515.45 | |
Martin's Point
| Facility | $11,011.45 | $11,011.45 | $16,515.45 |