| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,152.66 | $1,152.66 | $9,500.00 | |
Medica
| Facility | $1,152.66 | $1,498.46 | $3,240.00 | |
United
| Facility | $1,978.00 | $1,978.00 | $3,240.00 |
Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,152.66 | $1,152.66 | $9,500.00 | |
Medica
| Facility | $1,152.66 | $1,498.46 | $3,240.00 | |
United
| Facility | $1,978.00 | $1,978.00 | $3,240.00 |