| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $4,428.99 | $4,428.99 | $6,528.11 | |
Medica
| Facility | $10,460.00 | $10,460.00 | $10,460.00 |
Lithotripsy - General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $4,428.99 | $4,428.99 | $6,528.11 | |
Medica
| Facility | $10,460.00 | $10,460.00 | $10,460.00 |