| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $21.55 | $39.88 | $52.02 |
Hally Health
| Professional | 26 | $26.25 | $37.79 | $93.71 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $21.55 | $39.88 | $52.02 |
Hally Health
| Professional | 26 | $26.25 | $37.79 | $93.71 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |