| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $507.78 | $2,379.92 | $3,873.20 | |
Aetna
| Professional | $507.78 | $507.78 | $910.21 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $489.34 | $489.34 | $489.34 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $873.16 | $873.16 | $873.16 |