| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sentara
| Facility | $10,654.00 | $14,351.00 | $17,021.00 |
Urinary Stones W Esw Lithotripsy W/O Cc/Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Sentara
| Facility | $10,654.00 | $14,351.00 | $17,021.00 |