| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,165.05 | $4,379.25 | $6,776.88 | |
Cigna
| Facility | $5,500.00 | $5,500.00 | $5,500.00 |
Lithotripsy - General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,165.05 | $4,379.25 | $6,776.88 | |
Cigna
| Facility | $5,500.00 | $5,500.00 | $5,500.00 |