| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.88 | $12.88 | $12.88 | |
BCBS
| Facility | $47,000.00 | $77,999.99 | $94,999.99 | |
Cigna
| Facility | $139.34 | $139.34 | $139.34 | |
Providence
| Facility | $89.72 | $306.77 | $618.41 |
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 | $12.88 | $12.88 | $12.88 | |
BCBS
| Facility | $47,000.00 | $77,999.99 | $94,999.99 | |
Cigna
| Facility | $139.34 | $139.34 | $139.34 | |
Providence
| Facility | $89.72 | $306.77 | $618.41 |