| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $25.75 | $25.75 | $95.65 |
AllWays Health Partners
| Facility | 26 | $130.34 | $137.03 | $269.66 |
Mass General Brigham
| Facility | 26 | $130.34 | $269.66 | $269.66 |
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 | $25.75 | $25.75 | $95.65 |
AllWays Health Partners
| Facility | 26 | $130.34 | $137.03 | $269.66 |
Mass General Brigham
| Facility | 26 | $130.34 | $269.66 | $269.66 |