| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $649.01 | $2,173.00 | $4,730.00 | |
Aetna
| Professional | $27.58 | $27.58 | $27.58 | |
Anthem BCBS
| Facility | $2,779.00 | $3,647.00 | $4,098.00 | |
Cigna
| Facility | $345.41 | $345.41 | $345.41 | |
Hometown Health
| Professional | $200.00 | $200.00 | $200.00 | |
Hometown Health
| Facility | $676.51 | $676.51 | $676.51 | |
United
| Facility | $200.00 | $1,427.00 | $1,998.00 |