| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $47.86 | $77.62 | $181.97 |
Cigna
| Facility | 26 | $13.49 | $63.10 | $89.13 |
Univera
| Facility | 26 | $37.15 | $64.57 | $112.20 |
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 | $47.86 | $77.62 | $181.97 |
Cigna
| Facility | 26 | $13.49 | $63.10 | $89.13 |
Univera
| Facility | 26 | $37.15 | $64.57 | $112.20 |