| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.05 | $67.05 | $67.05 | |
Aetna
| Professional | $67.05 | $67.05 | $77.59 | |
Anthem BCBS
| Professional | $67.09 | $83.34 | $105.89 | |
Hometown Health
| Facility | $41.21 | $41.21 | $41.21 | |
United
| Facility | $1,061.00 | $2,606.00 | $6,471.00 | |
United
| Professional | $34.57 | $68.88 | $111.53 |