| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.09 | $65.09 | $65.09 | |
Cigna
| Facility | $62.00 | $108.00 | $114.00 | |
Hally Health
| Facility | $100.00 | $120.00 | $345.40 |
Clinic - Pediatric Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.09 | $65.09 | $65.09 | |
Cigna
| Facility | $62.00 | $108.00 | $114.00 | |
Hally Health
| Facility | $100.00 | $120.00 | $345.40 |