| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $36.26 | $50.37 | $55.20 |
Cigna
| Facility | 26 | $63.29 | $63.29 | $63.29 |
Medcost
| Facility | 26 | $49.85 | $57.00 | $102.75 |
Wellcare
| 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 | $36.26 | $50.37 | $55.20 |
Cigna
| Facility | 26 | $63.29 | $63.29 | $63.29 |
Medcost
| Facility | 26 | $49.85 | $57.00 | $102.75 |
Wellcare
| Facility | 26 | $130.34 | $269.66 | $269.66 |