| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.65 | $1,614.65 | $8,500.00 | |
Medica
| Facility | $1,614.65 | $2,298.56 | $4,843.95 |
Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,614.65 | $1,614.65 | $8,500.00 | |
Medica
| Facility | $1,614.65 | $2,298.56 | $4,843.95 |