| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.75 | $30.75 | $30.75 |
Health Alliance Plan
| Facility | 26 | $21.45 | $21.45 | $30.75 |
Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and images, radiological supervision and interpretation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.75 | $30.75 | $30.75 |
Health Alliance Plan
| Facility | 26 | $21.45 | $21.45 | $30.75 |