| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.50 | $550.40 | $695.68 | |
Pacific Source
| Facility | $356.00 | $416.00 | $602.00 |
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.50 | $550.40 | $695.68 | |
Pacific Source
| Facility | $356.00 | $416.00 | $602.00 |