| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Pacific Source
| Facility | $234.01 | $314.39 | $363.80 |
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 | $234.01 | $314.39 | $363.80 |