| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $13.09 | $13.09 | $13.09 |
Midlands
| Facility | 26 | $45.76 | $45.76 | $45.76 |
Sanford Health Plan
| Professional | 26 | $17.30 | $22.70 | $25.88 |
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 | $13.09 | $13.09 | $13.09 |
Midlands
| Facility | 26 | $45.76 | $45.76 | $45.76 |
Sanford Health Plan
| Professional | 26 | $17.30 | $22.70 | $25.88 |