| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.02 | $2.02 | $2.02 | |
Cigna
| Professional | $1.18 | $1.65 | $2.40 | |
MVP Health Care
| Professional | $2.40 | $2.40 | $2.40 | |
United
| Professional | $0.78 | $3.44 | $3.68 |
Stomach Tube - Levine Type (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.02 | $2.02 | $2.02 | |
Cigna
| Professional | $1.18 | $1.65 | $2.40 | |
MVP Health Care
| Professional | $2.40 | $2.40 | $2.40 | |
United
| Professional | $0.78 | $3.44 | $3.68 |