| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $671.95 | $712.27 | $853.38 | |
Hometown Health
| Professional | $717.08 | $796.75 | $796.75 | |
Hometown Health
| Professional | $796.75 | $796.75 | $796.75 | |
United
| Facility | $401.38 | $401.38 | $401.83 |