| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.66 | $629.84 | $1,400.00 | |
CareSource
| Facility | $53.38 | $59.59 | $64.92 | |
Cigna
| Facility | $85.60 | $85.60 | $85.60 |
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 | $48.66 | $629.84 | $1,400.00 | |
CareSource
| Facility | $53.38 | $59.59 | $64.92 | |
Cigna
| Facility | $85.60 | $85.60 | $85.60 |