| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.57 | $87.57 | $87.57 | |
Aetna
| Professional | $87.57 | $87.57 | $755.47 | |
Anthem BCBS
| Professional | $40.17 | $66.93 | $158.81 | |
Cigna
| Professional | $57.90 | $150.00 | $249.00 | |
Hometown Health
| Professional | $1.50 | $1.50 | $200.00 | |
Hometown Health
| Professional | $1.50 | $1.50 | $1.50 |