| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $254.94 | $254.94 | $254.94 | |
Aetna
| Professional | $17.60 | $254.94 | $622.74 | |
Anthem BCBS
| Professional | $15.94 | $25.00 | $31.12 | |
Cigna
| Professional | $15.08 | $15.08 | $15.08 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 |