| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.15 | $1.15 | $1.32 | |
Hometown Health
| Professional | $1.09 | $2.70 | $14.01 | |
Hometown Health
| Facility | $723.21 | $723.21 | $723.21 | |
United
| Facility | $408.00 | $1,925.00 | $4,715.00 |