| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $139.97 | $139.97 | $141.46 | |
Aetna
| Professional | $101.03 | $124.63 | $161.94 | |
Ambetter
| Professional | $99.85 | $99.85 | $99.85 | |
Anthem BCBS
| Professional | $99.44 | $128.05 | $171.53 | |
Cigna
| Professional | $89.33 | $131.58 | $202.26 | |
Hometown Health
| Professional | $0.75 | $124.51 | $155.63 | |
Hometown Health
| Facility | $172.92 | $172.92 | $172.92 | |
Hometown Health
| Professional | $106.12 | $116.29 | $126.31 | |
United
| Professional | $109.31 | $148.75 | $264.52 |