| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $478.63 | $602.56 | $1,905.46 | |
Cigna
| Professional | $407.38 | $660.69 | $1,071.52 | |
United
| Professional | $501.19 | $707.95 | $1,949.84 |
Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $478.63 | $602.56 | $1,905.46 | |
Cigna
| Professional | $407.38 | $660.69 | $1,071.52 | |
United
| Professional | $501.19 | $707.95 | $1,949.84 |