| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.64 | $19.64 | $8,500.00 | |
Aetna
| Facility | 52 | $9.83 | $9.83 | $9.83 |
Medica
| Facility | $19.50 | $27.60 | $56.99 | |
United
| Facility | $681.00 | $681.00 | $681.00 |
Introduction Long Gi Tube Separate Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.64 | $19.64 | $8,500.00 | |
Aetna
| Facility | 52 | $9.83 | $9.83 | $9.83 |
Medica
| Facility | $19.50 | $27.60 | $56.99 | |
United
| Facility | $681.00 | $681.00 | $681.00 |