| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $751.56 | $2,112.84 | $2,112.84 | |
Aetna
| Professional | $717.57 | $751.56 | $890.93 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $873.16 | $873.16 | $873.16 |