| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.68 | $169.63 | $1,600.00 | |
CareSource
| Facility | $114.59 | $131.38 | $143.13 | |
Cigna
| Facility | $121.52 | $121.52 | $121.52 |
Peritoneal lavage, including imaging guidance, when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.68 | $169.63 | $1,600.00 | |
CareSource
| Facility | $114.59 | $131.38 | $143.13 | |
Cigna
| Facility | $121.52 | $121.52 | $121.52 |