| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,751.11 | $4,925.43 | $7,159.62 | |
Cigna
| Facility | $4,442.00 | $4,442.00 | $5,279.00 | |
Qualchoice
| Facility | $4,313.78 | $5,533.55 | $8,233.56 |
Lithotripsy - General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,751.11 | $4,925.43 | $7,159.62 | |
Cigna
| Facility | $4,442.00 | $4,442.00 | $5,279.00 | |
Qualchoice
| Facility | $4,313.78 | $5,533.55 | $8,233.56 |