| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $260.39 | $268.29 | $301.30 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 |
Unlisted Immunology
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $260.39 | $268.29 | $301.30 | |
Hally Health
| Professional | $150.00 | $150.00 | $150.00 |