| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.85 | $48.85 | $48.85 |
Sanford Health Plan
| Professional | 26 | $61.97 | $81.73 | $87.90 |
Gi Tract Imaging Intraluminal Esophagus Wi&R
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $48.85 | $48.85 | $48.85 |
Sanford Health Plan
| Professional | 26 | $61.97 | $81.73 | $87.90 |