| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $432.12 | $432.12 | $8,500.00 | |
Medica
| Facility | $432.12 | $544.88 | $1,296.35 |
Preperitoneal Pel Pack F/Hemrrg Assoc Pel Trma
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $432.12 | $432.12 | $8,500.00 | |
Medica
| Facility | $432.12 | $544.88 | $1,296.35 |