| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $63.10 | $114.82 | $123.03 |
Medica
| Facility | 26 | $131.83 | $131.83 | $245.47 |
Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $63.10 | $114.82 | $123.03 |
Medica
| Facility | 26 | $131.83 | $131.83 | $245.47 |