| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $314.18 | $448.16 | $739.91 | |
Aetna
| Professional | $314.18 | $314.18 | $450.36 | |
Cigna
| Professional | $52.02 | $52.02 | $52.02 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $394.69 | $394.69 | $394.69 |