| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.98 | $182.98 | $196.05 | |
Aetna
| Professional | $178.06 | $182.98 | $232.29 | |
Anthem BCBS
| Professional | $208.81 | $210.06 | $509.00 | |
Hometown Health
| Professional | $200.00 | $401.29 | $493.00 | |
Hometown Health
| Facility | $1,837.51 | $1,837.51 | $1,837.51 |