| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.01 | $22.28 | $125.62 |
Cigna
| Facility | 26 | $22.12 | $22.12 | $35.49 |
Medica
| Facility | 26 | $51.77 | $129.00 | $129.00 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.01 | $22.28 | $125.62 |
Cigna
| Facility | 26 | $22.12 | $22.12 | $35.49 |
Medica
| Facility | 26 | $51.77 | $129.00 | $129.00 |