| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $34.18 | $34.18 | $42.25 |
Providence
| Facility | 26 | $34.18 | $34.18 | $42.25 |
Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $34.18 | $34.18 | $42.25 |
Providence
| Facility | 26 | $34.18 | $34.18 | $42.25 |