| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $77.62 | $77.62 | $77.62 | |
MountainHealth Co-op
| Facility | $83.18 | $1,202.26 | $1,318.26 | |
Providence
| Facility | $51.29 | $676.08 | $1,698.24 |
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 |
|---|---|---|---|---|---|
Cigna
| Facility | $77.62 | $77.62 | $77.62 | |
MountainHealth Co-op
| Facility | $83.18 | $1,202.26 | $1,318.26 | |
Providence
| Facility | $51.29 | $676.08 | $1,698.24 |