| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.38 | $184.38 | $221.34 | |
Aetna
| Professional | $184.38 | $184.38 | $221.34 | |
Cigna
| Facility | $868.33 | $868.33 | $868.33 | |
Hometown Health
| Professional | $564.92 | $564.92 | $693.32 | |
Hometown Health
| Facility | $959.66 | $959.66 | $959.66 |