| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,142.00 | $2,142.00 | $2,142.00 | |
Anthem BCBS
| Facility | $1,629.00 | $2,033.00 | $2,567.00 | |
Sentara
| Facility | $19.89 | $5,098.00 | $10,945.00 |
Lithotripsy - General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,142.00 | $2,142.00 | $2,142.00 | |
Anthem BCBS
| Facility | $1,629.00 | $2,033.00 | $2,567.00 | |
Sentara
| Facility | $19.89 | $5,098.00 | $10,945.00 |