| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.32 | $20.32 | $20.32 | |
Aetna
| Professional | $17.37 | $19.27 | $21.43 | |
Anthem BCBS
| Professional | $22.15 | $22.15 | $41.00 | |
Hometown Health
| Professional | $50.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $142.41 | $142.41 | $142.41 |