| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $346.09 | $346.09 | $346.09 | |
Anthem BCBS
| Facility | $17,593.00 | $22,182.00 | $35,915.00 | |
Anthem BCBS
| Professional | $143.82 | $206.84 | $588.19 | |
Hometown Health
| Professional | $2.45 | $2.50 | $250.00 | |
Hometown Health
| Professional | $2.50 | $2.50 | $2.50 |