| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $18.96 | $19.82 | $119.39 |
Cigna
| Facility | 26 | $25.18 | $25.18 | $27.29 |
Lucent Health
| Facility | 26 | $100.00 | $129.00 | $129.00 |
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 | $18.96 | $19.82 | $119.39 |
Cigna
| Facility | 26 | $25.18 | $25.18 | $27.29 |
Lucent Health
| Facility | 26 | $100.00 | $129.00 | $129.00 |