| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $423.01 | $423.01 | $423.01 | |
Anthem BCBS
| Facility | $17,593.00 | $22,182.00 | $35,915.00 | |
Anthem BCBS
| Professional | $143.82 | $206.84 | $623.38 | |
Hometown Health
| Professional | $2.70 | $2.75 | $275.00 | |
Hometown Health
| Professional | $2.75 | $2.75 | $2.75 |