| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,993.72 | $3,787.95 | $11,948.34 | |
United
| Facility | $3,599.00 | $7,228.00 | $12,680.00 |
Perq Nl/Pl Lithotrp Simple Up To 2 Cm 1 Location
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,993.72 | $3,787.95 | $11,948.34 | |
United
| Facility | $3,599.00 | $7,228.00 | $12,680.00 |