| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $3,525.24 | $9,859.00 | |
Anthem BCBS
| Facility | $8,992.79 | $9,992.00 | $19,050.00 | |
United
| Facility | $11,155.00 | $11,155.00 | $11,155.00 |
Perq Nl/Pl Lithotrp Simple Up To 2 Cm 1 Location
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $3,525.24 | $9,859.00 | |
Anthem BCBS
| Facility | $8,992.79 | $9,992.00 | $19,050.00 | |
United
| Facility | $11,155.00 | $11,155.00 | $11,155.00 |