| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.76 | $45.76 | $216.80 | |
Aetna
| Professional | $45.76 | $45.76 | $216.80 | |
Cigna
| Facility | $564.50 | $564.50 | $564.50 | |
Hometown Health
| Professional | $999.57 | $999.57 | $1,226.75 | |
Hometown Health
| Facility | $623.87 | $623.87 | $623.87 |