| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Facility | $100.00 | $120.00 | $345.40 |
Patient Convenience Items-Other Convenience Items
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Hally Health
| Facility | $100.00 | $120.00 | $345.40 |