| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.41 | $109.41 | $112.05 | |
Aetna
| Professional | $105.46 | $109.41 | $112.05 | |
Anthem BCBS
| Professional | $68.94 | $68.94 | $69.62 | |
Cigna
| Facility | $112.05 | $112.05 | $112.05 | |
Cigna
| Professional | $112.05 | $112.05 | $112.05 | |
Hometown Health
| Professional | $100.00 | $131.82 | $150.00 |