| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $1,684.00 | $11,827.57 | $19,468.40 |
Urinary Stones W Esw Lithotripsy W/O Cc/Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Blue Shield
| Facility | $1,684.00 | $11,827.57 | $19,468.40 |