| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $63.68 | $116.86 | $202.11 |
Hally Health
| Professional | 26 | $70.81 | $104.30 | $444.36 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Card Bl Pool Plnr Mlt Stdy Wal Motn Eject Fract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $63.68 | $116.86 | $202.11 |
Hally Health
| Professional | 26 | $70.81 | $104.30 | $444.36 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |