| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $333.12 | $333.12 | $333.12 | |
Anthem BCBS
| Facility | $17,593.00 | $22,182.00 | $35,915.00 | |
Anthem BCBS
| Professional | $161.47 | $232.21 | $697.05 | |
Hometown Health
| Professional | $3.04 | $3.10 | $310.00 | |
Hometown Health
| Professional | $3.10 | $3.10 | $3.10 |