| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $12,602.40 | $12,602.40 | $12,602.40 |
ExtraCorporeal Shock Wave Therapy (formerly Lithotripsy)-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $12,602.40 | $12,602.40 | $12,602.40 |