| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.59 | $108.59 | $122.66 | |
Aetna
| Professional | $23.45 | $23.45 | $37.74 | |
Cigna
| Facility | $22.99 | $41.38 | $128.05 | |
Cigna
| Professional | $31.00 | $31.00 | $31.00 | |
Hometown Health
| Professional | $190.00 | $190.00 | $190.00 |