| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $172.73 | $192.49 | $230.31 | |
Cigna
| Facility | $350.00 | $350.00 | $350.00 | |
Hometown Health
| Professional | $1.95 | $220.00 | $343.56 | |
Hometown Health
| Professional | 25 | $1,324.38 | $1,324.38 | $1,324.38 |