| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $12.71 | $22.50 | $46.22 |
Cigna
| Facility | 26 | $15.01 | $15.01 | $16.42 |
Medical Mutual of Ohio
| Facility | 26 | $15.01 | $15.01 | $16.42 |
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 | $12.71 | $22.50 | $46.22 |
Cigna
| Facility | 26 | $15.01 | $15.01 | $16.42 |
Medical Mutual of Ohio
| Facility | 26 | $15.01 | $15.01 | $16.42 |