| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $977.24 | $977.24 | $977.24 |
Martin's Point
| Facility | QX | $977.24 | $977.24 | $977.24 |
Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $977.24 | $977.24 | $977.24 |
Martin's Point
| Facility | QX | $977.24 | $977.24 | $977.24 |