| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $56.81 | $56.81 | $56.81 |
Midlands
| Facility | 26 | $111.93 | $111.93 | $111.93 |
Sanford Health Plan
| Professional | 26 | $42.48 | $79.09 | $106.09 |
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 | $56.81 | $56.81 | $56.81 |
Midlands
| Facility | 26 | $111.93 | $111.93 | $111.93 |
Sanford Health Plan
| Professional | 26 | $42.48 | $79.09 | $106.09 |