| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $56.25 | $56.25 | $56.25 |
Hally Health
| Professional | 26 | $68.77 | $68.77 | $83.18 |
Regence BlueShield
| Facility | 26 | $936.81 | $936.81 | $936.81 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $56.25 | $56.25 | $56.25 |
Hally Health
| Professional | 26 | $68.77 | $68.77 | $83.18 |
Regence BlueShield
| Facility | 26 | $936.81 | $936.81 | $936.81 |