| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.91 | $65.91 | $65.91 | |
Aetna
| Professional | $65.91 | $65.91 | $65.91 | |
Cigna
| Facility | $37.04 | $37.04 | $37.04 | |
Hometown Health
| Professional | $38.79 | $38.79 | $47.60 | |
Hometown Health
| Facility | $40.94 | $40.94 | $40.94 |