| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $288.40 | $407.38 | $616.60 | |
Hometown Health
| Professional | $0.45 | $123.03 | $177.83 | |
Hometown Health
| Professional | $0.45 | $144.54 | $190.55 | |
United
| Professional | $40.74 | $109.65 | $177.83 |