| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $31.05 | $75.11 | $93.88 |
Cigna
| Facility | 26 | $25.18 | $25.18 | $25.18 |
Medica
| Facility | 26 | $129.00 | $129.00 | $129.00 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $31.05 | $75.11 | $93.88 |
Cigna
| Facility | 26 | $25.18 | $25.18 | $25.18 |
Medica
| Facility | 26 | $129.00 | $129.00 | $129.00 |