| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.95 | $40.74 | $102.33 |
BCBS
| Facility | 26 | $25.12 | $25.12 | $25.12 |
Cigna
| Facility | 26 | $5.37 | $28.84 | $69.18 |
Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $19.95 | $40.74 | $102.33 |
BCBS
| Facility | 26 | $25.12 | $25.12 | $25.12 |
Cigna
| Facility | 26 | $5.37 | $28.84 | $69.18 |
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