| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $1,684.00 | $16,585.50 | $27,300.04 |
Urinary Stones W Esw Lithotripsy W Cc/Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $1,684.00 | $16,585.50 | $27,300.04 |