| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $485.00 | $485.00 | $485.00 | |
Cigna
| Facility | $262.00 | $275.00 | $400.00 | |
United
| Facility | $358.00 | $358.00 | $358.00 |
Peritoneal / Composite Or Ot
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $485.00 | $485.00 | $485.00 | |
Cigna
| Facility | $262.00 | $275.00 | $400.00 | |
United
| Facility | $358.00 | $358.00 | $358.00 |