| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Hally Health
| Professional | $120.23 | $169.82 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |
Miscellaneous DME supply or accessory, not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
Hally Health
| Professional | $120.23 | $169.82 | $346.74 | |
Hally Health
| Facility | $100.00 | $100.00 | $100.00 |