| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.19 | $10.19 | $10.19 | |
Hally Health
| Professional | $22.28 | $49.82 | $100.00 |
Nonemergency transportation and bus, intra- or interstate carrier
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.19 | $10.19 | $10.19 | |
Hally Health
| Professional | $22.28 | $49.82 | $100.00 |