| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $4,452.00 | $5,379.00 | $8,190.00 | |
Hometown Health
| Professional | $16.07 | $1,016.48 | $1,778.84 | |
Hometown Health
| Professional | $12.06 | $1,016.48 | $1,524.72 | |
United
| Professional | $30.00 | $30.00 | $51.00 |