| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $805.34 | $830.21 | $3,301.55 | |
Cigna
| Facility | $149.68 | $149.68 | $456.00 | |
Martin's Point
| Facility | $805.34 | $830.21 | $3,301.55 |
Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $805.34 | $830.21 | $3,301.55 | |
Cigna
| Facility | $149.68 | $149.68 | $456.00 | |
Martin's Point
| Facility | $805.34 | $830.21 | $3,301.55 |