| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,826.44 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $63.40 | $388.20 | $4,674.70 | |
Providence
| Facility | $63.40 | $388.20 | $4,674.70 |
Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,826.44 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $63.40 | $388.20 | $4,674.70 | |
Providence
| Facility | $63.40 | $388.20 | $4,674.70 |