| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Anthem BCBS
| Professional | $43.92 | $43.92 | $43.92 | |
Hometown Health
| Professional | $100.00 | $200.00 | $493.00 |