| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.66 | $163.66 | $1,400.00 | |
CareSource
| Facility | $166.44 | $191.26 | $208.37 | |
Cigna
| Facility | $179.16 | $179.16 | $179.16 | |
Cigna
| Facility | AS | $17.41 | $17.41 | $17.41 |
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 | $163.66 | $163.66 | $1,400.00 | |
CareSource
| Facility | $166.44 | $191.26 | $208.37 | |
Cigna
| Facility | $179.16 | $179.16 | $179.16 | |
Cigna
| Facility | AS | $17.41 | $17.41 | $17.41 |