| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $299.74 | $299.74 | $299.74 | |
Aetna
| Professional | $299.74 | $299.74 | $454.77 | |
Anthem BCBS
| Professional | $58.51 | $95.88 | $127.56 | |
Cigna
| Professional | $49.95 | $49.95 | $49.95 | |
Hometown Health
| Professional | $1.75 | $1.75 | $31.50 | |
Hometown Health
| Professional | $1.75 | $1.75 | $1.75 |