| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.00 | $64.00 | $159.81 | |
Aetna
| Professional | $64.00 | $64.00 | $159.81 | |
Cigna
| Facility | $96.56 | $96.56 | $96.56 | |
Hometown Health
| Professional | $109.78 | $109.78 | $134.72 | |
Hometown Health
| Facility | $106.72 | $106.72 | $106.72 |