| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.44 | $124.44 | $124.44 | |
Aetna
| Professional | $103.61 | $122.43 | $305.00 | |
Anthem BCBS
| Professional | $114.25 | $157.60 | $241.16 | |
Cigna
| Professional | $116.00 | $156.60 | $250.15 | |
Hometown Health
| Professional | $1.72 | $137.96 | $201.20 | |
Hometown Health
| Professional | $1.72 | $114.97 | $172.46 | |
United
| Professional | $120.28 | $154.16 | $256.10 |