| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $10,471.29 | $15,488.17 | $18,197.01 | |
Cigna
| Facility | $10,232.93 | $12,022.64 | $23,442.29 | |
Harvard Pilgrim
| Facility | $12,022.64 | $12,022.64 | $12,022.64 |
Urinary Stones Without Mcc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $10,471.29 | $15,488.17 | $18,197.01 | |
Cigna
| Facility | $10,232.93 | $12,022.64 | $23,442.29 | |
Harvard Pilgrim
| Facility | $12,022.64 | $12,022.64 | $12,022.64 |