| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $557.80 | $557.80 | $557.80 | |
Anthem BCBS
| Facility | $17,593.00 | $22,182.00 | $35,915.00 | |
Anthem BCBS
| Professional | $161.80 | $232.69 | $659.80 | |
Hometown Health
| Professional | $2.94 | $3.00 | $300.00 | |
Hometown Health
| Professional | $3.00 | $3.00 | $3.00 |