| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $14.62 | $17.73 | $29.19 |
Medica
| Facility | 26 | $31.19 | $31.19 | $100.00 |
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 | $14.62 | $17.73 | $29.19 |
Medica
| Facility | 26 | $31.19 | $31.19 | $100.00 |