| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $112.41 | $112.41 | $141.35 | |
Hally Health
| Professional | $100.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |
Iv Us Non-C Vsl Dx Eval&/Ther Ivntj Ea Vsl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $112.41 | $112.41 | $141.35 | |
Hally Health
| Professional | $100.00 | $200.00 | $345.40 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |