| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.33 | $34.33 | $34.33 |
Hally Health
| Professional | 26 | $63.48 | $63.48 | $76.78 |
Cineradiography/videoradiography to complement routine examination (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.33 | $34.33 | $34.33 |
Hally Health
| Professional | 26 | $63.48 | $63.48 | $76.78 |