| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $1.08 | $131.21 | $218.68 | |
Hometown Health
| Professional | $1.08 | $1.08 | $1.08 |
Radex Gi Tract Upr W/Sm Int W/Mult Serial Images
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hometown Health
| Professional | $1.08 | $131.21 | $218.68 | |
Hometown Health
| Professional | $1.08 | $1.08 | $1.08 |