| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.29 | $114.17 | $158.80 | |
Aetna
| Professional | $62.45 | $87.67 | $150.00 | |
Aetna
| Professional | 25 | $145.34 | $145.34 | $145.34 |
Anthem BCBS
| Professional | $72.92 | $100.36 | $154.41 | |
Cigna
| Professional | $61.41 | $93.87 | $155.61 | |
Hometown Health
| Professional | $0.70 | $94.14 | $172.38 | |
Hometown Health
| Facility | $177.57 | $177.57 | $177.57 | |
Hometown Health
| Professional | $78.45 | $86.36 | $130.99 | |
United
| Professional | $62.14 | $92.16 | $183.16 |