| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.05 | $19.05 | $19.05 | |
Aetna
| Professional | $19.05 | $19.05 | $19.95 | |
Anthem BCBS
| Professional | $14.79 | $15.85 | $19.95 | |
Hometown Health
| Professional | $12.59 | $20.89 | $23.99 | |
Select Health
| Professional | $17.38 | $17.38 | $17.38 | |
United
| Professional | $23.99 | $23.99 | $33.11 |