| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $888.20 | $2,761.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $111.19 | $790.75 | $1,730.74 | |
United
| Facility | $808.00 | $1,171.00 | $26,408.00 |
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 | $888.20 | $2,761.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $111.19 | $790.75 | $1,730.74 | |
United
| Facility | $808.00 | $1,171.00 | $26,408.00 |