| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,071.52 | $12,022.64 | $16,595.87 | |
Moda Health
| Facility | $346.74 | $512.86 | $1,412.54 | |
Providence
| Facility | $416.87 | $537.03 | $1,412.54 |
Omental flap, intra-abdominal (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,071.52 | $12,022.64 | $16,595.87 | |
Moda Health
| Facility | $346.74 | $512.86 | $1,412.54 | |
Providence
| Facility | $416.87 | $537.03 | $1,412.54 |