| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $14,381.44 | $14,381.44 | $14,381.44 |
Urinary Stones W Esw Lithotripsy W Cc/Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $14,381.44 | $14,381.44 | $14,381.44 |