| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $54.60 | $54.60 | $54.60 |
Health Alliance Plan
| Facility | 26 | $38.04 | $38.04 | $54.60 |
Acute gastrointestinal blood loss imaging
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $54.60 | $54.60 | $54.60 |
Health Alliance Plan
| Facility | 26 | $38.04 | $38.04 | $54.60 |