| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $126.59 | $595.39 | $1,564.70 | |
Cigna
| Professional | $222.00 | $222.00 | $222.00 | |
Hometown Health
| Professional | $190.00 | $190.00 | $190.00 | |
Hometown Health
| Facility | $247.70 | $247.70 | $247.70 |