| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $808.50 | $1,706.00 | $4,473.00 | |
Anthem BCBS
| Facility | $630.00 | $630.00 | $630.00 | |
Hometown Health
| Professional | $2.40 | $133.60 | $187.04 | |
United
| Facility | $200.00 | $1,427.00 | $1,998.00 |