| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $65.98 | $65.98 | $65.98 |
Midlands
| Facility | 26 | $221.44 | $221.44 | $221.44 |
Sanford Health Plan
| Professional | 26 | $84.41 | $111.21 | $126.79 |
Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $65.98 | $65.98 | $65.98 |
Midlands
| Facility | 26 | $221.44 | $221.44 | $221.44 |
Sanford Health Plan
| Professional | 26 | $84.41 | $111.21 | $126.79 |