| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $169.82 | $169.82 | $177.83 | |
Pacific Source
| Facility | $1,698.24 | $2,344.23 | $2,398.83 |
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 |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $169.82 | $169.82 | $177.83 | |
Pacific Source
| Facility | $1,698.24 | $2,344.23 | $2,398.83 |