| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $3,182.22 | $3,182.22 | $3,812.66 | |
Hometown Health
| Professional | $566.01 | $628.90 | $628.90 | |
Hometown Health
| Professional | $628.90 | $628.90 | $628.90 | |
United
| Professional | $30.00 | $34.57 | $2,767.16 |