| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $12.88 | $12.88 | $12.88 |
Midlands
| Professional | 26 | $26.30 | $28.18 | $32.36 |
Sanford Health Plan
| Professional | 26 | $15.85 | $22.39 | $25.70 |
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 | $12.88 | $12.88 | $12.88 |
Midlands
| Professional | 26 | $26.30 | $28.18 | $32.36 |
Sanford Health Plan
| Professional | 26 | $15.85 | $22.39 | $25.70 |