| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.40 | $66.77 | $101.04 |
Hally Health
| Professional | 26 | $35.36 | $53.49 | $230.16 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Rp Loclzj Tum Plnr 2+Area 1+D Img/1 Area Img>2+D
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.40 | $66.77 | $101.04 |
Hally Health
| Professional | 26 | $35.36 | $53.49 | $230.16 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |