| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,304.89 | $4,200.64 | $5,450.48 | |
Cigna
| Facility | $14,188.85 | $14,188.85 | $14,188.85 |
Lithotripsy - General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $3,304.89 | $4,200.64 | $5,450.48 | |
Cigna
| Facility | $14,188.85 | $14,188.85 | $14,188.85 |