| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $87.10 | $87.10 | |
Aetna
| Professional | $87.10 | $87.10 | $398.11 | |
Anthem BCBS
| Professional | $41.69 | $69.18 | $162.18 | |
Cigna
| Professional | $50.12 | $151.36 | $251.19 | |
Hometown Health
| Professional | $1.51 | $1.51 | $2.40 | |
Hometown Health
| Professional | $1.51 | $1.51 | $1.51 | |
United
| Professional | $144.54 | $151.36 | $186.21 |