| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $41.11 | $83.52 | $135.94 |
Radex Gi Upr W/Wo Glucose W/Sm Intest Follw-Thru
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $41.11 | $83.52 | $135.94 |