| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.28 | $123.60 | $170.11 | |
Aetna
| Professional | $94.83 | $147.24 | $453.00 | |
Ambetter
| Professional | $124.39 | $136.83 | $271.05 | |
Anthem BCBS
| Professional | $100.86 | $135.02 | $194.71 | |
Cigna
| Professional | $109.57 | $157.00 | $241.47 | |
Hometown Health
| Professional | $1.10 | $138.77 | $211.62 | |
Hometown Health
| Professional | 25 | $670.37 | $670.37 | $670.37 |
Hometown Health
| Professional | $1.10 | $115.64 | $210.00 | |
United
| Professional | $109.26 | $151.26 | $256.74 |