| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.22 | $117.22 | $117.22 | |
Aetna
| Professional | $44.99 | $104.34 | $118.51 | |
Anthem BCBS
| Professional | $109.41 | $134.66 | $193.58 | |
Hometown Health
| Facility | $331.45 | $331.45 | $331.45 | |
United
| Professional | $46.92 | $81.06 | $377.59 |