| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.70 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $157.02 | $834.95 | $1,168.93 | |
Providence
| Facility | $157.02 | $834.95 | $1,168.93 |
Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.70 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $157.02 | $834.95 | $1,168.93 | |
Providence
| Facility | $157.02 | $834.95 | $1,168.93 |