| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.56 | $4,396.00 | $10,300.00 | |
Aetna
| Professional | $68.69 | $77.56 | $90.13 | |
Anthem BCBS
| Professional | $38.34 | $55.52 | $88.57 | |
Hometown Health
| Professional | $100.00 | $110.00 | $350.00 | |
Hometown Health
| Facility | $41.21 | $41.21 | $41.21 | |
United
| Professional | $70.72 | $95.03 | $154.69 |