| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $894.76 | $894.76 | $9,500.00 | |
Medica
| Facility | $894.76 | $1,255.22 | $4,682.93 |
Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $894.76 | $894.76 | $9,500.00 | |
Medica
| Facility | $894.76 | $1,255.22 | $4,682.93 |