| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.70 | $66.70 | $66.70 | |
Aetna
| Professional | $66.70 | $66.70 | $82.81 | |
Anthem BCBS
| Professional | $46.62 | $56.09 | $73.77 | |
Hometown Health
| Facility | $41.21 | $41.21 | $41.21 | |
United
| Professional | $44.28 | $58.27 | $99.54 |