| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.47 | $251.47 | $269.43 | |
Aetna
| Professional | $169.72 | $251.47 | $269.43 | |
Anthem BCBS
| Professional | $220.80 | $288.62 | $288.62 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $1,637.08 | $1,637.08 | $1,637.08 |