| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.78 | $28.92 | $424.35 | |
Hometown Health
| Professional | $23.40 | $309.13 | $615.46 | |
Hometown Health
| Facility | $441.55 | $441.55 | $441.55 | |
United
| Facility | $26.78 | $26.78 | $26.78 |