| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.37 | $208.74 | $278.32 | |
Cigna
| Professional | $42.00 | $51.42 | $69.00 | |
Hometown Health
| Professional | $100.00 | $204.75 | $425.00 | |
Hometown Health
| Facility | $172.92 | $172.92 | $172.92 |