| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Providence
| Facility | $0.09 | $0.09 | $0.15 | |
Providence
| Professional | $0.07 | $79.43 | $85.11 |
High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Providence
| Facility | $0.09 | $0.09 | $0.15 | |
Providence
| Professional | $0.07 | $79.43 | $85.11 |