| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $53.23 | $53.23 | $102.73 |
Medica
| Facility | 26 | $104.23 | $104.23 | $219.84 |
Gi Tract Imaging Intraluminal Esophagus Wi&R
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $53.23 | $53.23 | $102.73 |
Medica
| Facility | 26 | $104.23 | $104.23 | $219.84 |