| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.57 | $2,626.00 | $8,084.00 | |
Horizon BCBS
| Facility | $1,847.80 | $2,216.56 | $4,227.18 | |
United
| Facility | $3,204.00 | $5,225.00 | $10,536.00 |
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 | $117.57 | $2,626.00 | $8,084.00 | |
Horizon BCBS
| Facility | $1,847.80 | $2,216.56 | $4,227.18 | |
United
| Facility | $3,204.00 | $5,225.00 | $10,536.00 |