| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.60 | $12.60 | $12.85 | |
Aetna
| Professional | $137.28 | $161.36 | $541.02 | |
Cigna
| Facility | $233.36 | $583.40 | $1,299.82 | |
Hometown Health
| Professional | $190.00 | $190.00 | $190.00 |