| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $44.30 | $107.16 | $133.94 |
Medica
| Facility | 26 | $74.90 | $143.13 | $143.13 |
Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $44.30 | $107.16 | $133.94 |
Medica
| Facility | 26 | $74.90 | $143.13 | $143.13 |