| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,331.00 | $20,631.20 | $26,539.90 | |
Highmark BCBS
| Facility | $8,169.59 | $8,864.77 | $26,264.48 |
Perq Nl/Pl Lithotrp Complex >2 Cm Mlt Locations
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,331.00 | $20,631.20 | $26,539.90 | |
Highmark BCBS
| Facility | $8,169.59 | $8,864.77 | $26,264.48 |