| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $20.87 | $22.71 | $27.25 |
Hometown Health
| Professional | 26 | $0.52 | $28.02 | $35.99 |
Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $20.87 | $22.71 | $27.25 |
Hometown Health
| Professional | 26 | $0.52 | $28.02 | $35.99 |