| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,642.00 | $4,793.00 | $7,802.00 | |
Aetna
| Professional | $13,753.37 | $13,753.37 | $13,753.37 | |
Anthem BCBS
| Facility | $6,556.00 | $9,098.00 | $15,073.00 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $4,144.97 | $4,144.97 | $4,144.97 | |
United
| Facility | $1,780.00 | $3,644.00 | $9,042.00 |