| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $228.06 | $1,067.44 | $2,331.09 | |
Hometown Health
| Professional | $190.00 | $190.00 | $190.00 | |
Hometown Health
| Facility | $444.09 | $444.09 | $444.09 | |
United
| Facility | $848.52 | $848.52 | $848.52 |