| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $27.13 | $27.13 | $27.13 |
Regence BlueShield
| Facility | 26 | $878.86 | $878.86 | $878.86 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $27.13 | $27.13 | $27.13 |
Regence BlueShield
| Facility | 26 | $878.86 | $878.86 | $878.86 |