| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $234.42 | $323.59 | $363.08 |
Radex Gi Tract Upr W/Sm Int W/Mult Serial Images
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $234.42 | $323.59 | $363.08 |