| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.96 | $0.96 | $0.96 | |
Aetna
| Professional | $0.96 | $0.96 | $1.20 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $0.54 | $0.56 | $0.73 |
Low osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.96 | $0.96 | $0.96 | |
Aetna
| Professional | $0.96 | $0.96 | $1.20 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $0.54 | $0.56 | $0.73 |