| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.78 | $181.97 | $229.09 | |
Cigna
| Facility | $346.74 | $346.74 | $346.74 | |
Hometown Health
| Professional | $1.95 | $218.78 | $331.13 | |
Hometown Health
| Professional | 25 | $1,318.26 | $1,318.26 | $1,318.26 |