| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $165.96 | $165.96 | $165.96 |
Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $165.96 | $165.96 | $165.96 |