| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $15.12 | $15.12 | $15.87 |
Cigna
| Facility | 26 | $15.01 | $15.01 | $15.01 |
Health Alliance Plan
| Facility | 26 | $11.72 | $11.72 | $15.12 |
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 | $15.12 | $15.12 | $15.87 |
Cigna
| Facility | 26 | $15.01 | $15.01 | $15.01 |
Health Alliance Plan
| Facility | 26 | $11.72 | $11.72 | $15.12 |