| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.76 | $23.76 | $23.76 | |
Aetna
| Professional | $20.47 | $24.96 | $32.49 | |
Anthem BCBS
| Professional | $25.95 | $25.95 | $42.00 | |
Hometown Health
| Professional | $63.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $142.41 | $142.41 | $142.41 |