| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $38.50 | $44.27 | $53.26 |
Cigna
| Facility | 26 | $65.78 | $76.87 | $117.92 |
Medica
| Facility | 26 | $115.03 | $115.03 | $115.03 |
Quartz
| Facility | 26 | $28.97 | $115.03 | $115.03 |
Intro Long Gi Tube W/Mult Fluoro & Images Rs&I
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $38.50 | $44.27 | $53.26 |
Cigna
| Facility | 26 | $65.78 | $76.87 | $117.92 |
Medica
| Facility | 26 | $115.03 | $115.03 | $115.03 |
Quartz
| Facility | 26 | $28.97 | $115.03 | $115.03 |