| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $55.00 | $4,919.43 | $5,882.00 | |
Medica
| Facility | AS | $491.94 | $491.94 | $491.94 |
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $55.00 | $4,919.43 | $5,882.00 | |
Medica
| Facility | AS | $491.94 | $491.94 | $491.94 |