| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.40 | $304.86 | $2,000.00 | |
Medica
| Facility | $89.40 | $304.86 | $681.00 | |
United
| Facility | $681.00 | $681.00 | $681.00 |
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 | $89.40 | $304.86 | $2,000.00 | |
Medica
| Facility | $89.40 | $304.86 | $681.00 | |
United
| Facility | $681.00 | $681.00 | $681.00 |