| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.69 | $42.69 | $45.74 | |
Aetna
| Professional | $40.94 | $42.69 | $45.74 | |
Anthem BCBS
| Professional | $50.53 | $50.53 | $64.59 | |
Hometown Health
| Professional | $350.00 | $350.00 | $350.00 | |
Hometown Health
| Facility | $267.14 | $267.14 | $267.14 |