| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $245.93 | $245.93 | $245.93 | |
Anthem BCBS
| Facility | $14,662.00 | $18,485.00 | $35,915.00 | |
Anthem BCBS
| Professional | $154.13 | $221.68 | $667.60 | |
Hometown Health
| Professional | $2.94 | $3.00 | $300.00 | |
Hometown Health
| Professional | $3.00 | $3.00 | $3.00 |