| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $911.00 | $1,713.00 | $4,473.00 | |
Anthem BCBS
| Facility | $510.00 | $510.00 | $510.00 | |
Hometown Health
| Professional | $112.74 | $152.19 | $197.30 | |
United
| Facility | $200.00 | $1,427.00 | $1,998.00 |