| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.09 | $0.09 | $0.13 | |
Aetna
| Professional | $0.09 | $0.09 | $0.13 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |
High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.09 | $0.09 | $0.13 | |
Aetna
| Professional | $0.09 | $0.09 | $0.13 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |