| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $146.44 | $146.44 | $146.44 | |
Cigna
| Professional | $75.00 | $75.00 | $209.00 | |
Hometown Health
| Professional | $190.00 | $350.00 | $493.00 | |
Hometown Health
| Facility | $172.92 | $172.92 | $172.92 |