| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.86 | $45.41 | $45.41 |
Cigna
| Facility | 26 | $56.77 | $66.34 | $88.17 |
Medica
| Facility | 26 | $129.00 | $129.00 | $129.00 |
Quartz
| Facility | 26 | $100.00 | $129.00 | $129.00 |
Peritoneogram Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.86 | $45.41 | $45.41 |
Cigna
| Facility | 26 | $56.77 | $66.34 | $88.17 |
Medica
| Facility | 26 | $129.00 | $129.00 | $129.00 |
Quartz
| Facility | 26 | $100.00 | $129.00 | $129.00 |