| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $6,108.33 | $6,108.33 | $6,108.33 |
Urinary Stones W Esw Lithotripsy W/O Cc/Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $6,108.33 | $6,108.33 | $6,108.33 |