| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $29.95 | $29.95 | $29.95 |
Cigna
| Facility | 26 | $26.69 | $26.69 | $26.92 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $29.95 | $29.95 | $29.95 |
Cigna
| Facility | 26 | $26.69 | $26.69 | $26.92 |