| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.28 | $134.28 | $143.87 | |
Aetna
| Professional | $134.28 | $171.51 | $191.81 | |
Anthem BCBS
| Professional | $158.84 | $158.84 | $255.00 | |
Hometown Health
| Professional | $350.00 | $350.00 | $350.00 | |
Hometown Health
| Facility | $117.52 | $117.52 | $117.52 |