| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.14 | $16.14 | $16.14 | |
Aetna
| Professional | $14.31 | $16.14 | $19.87 | |
Anthem BCBS
| Professional | $17.64 | $17.64 | $28.75 | |
Hometown Health
| Professional | $52.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $142.41 | $142.41 | $142.41 |