| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.50 | $138.50 | $138.50 | |
Aetna
| Professional | $116.45 | $128.34 | $187.56 | |
Ambetter
| Professional | $112.54 | $112.54 | $112.54 | |
Anthem BCBS
| Professional | $103.20 | $134.60 | $217.80 | |
Cigna
| Professional | $110.71 | $143.97 | $230.84 | |
Hometown Health
| Professional | $1.90 | $124.78 | $175.82 | |
Hometown Health
| Professional | $1.90 | $105.28 | $157.91 | |
United
| Professional | $103.98 | $128.94 | $223.03 |