| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $246.02 | $246.02 | $263.58 | |
Aetna
| Professional | $232.17 | $246.02 | $263.58 | |
Anthem BCBS
| Professional | $282.39 | $282.39 | $282.39 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $3,584.18 | $3,584.18 | $3,584.18 |