| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.38 | $97.38 | $104.33 | |
Aetna
| Professional | $93.74 | $97.38 | $104.33 | |
Anthem BCBS
| Professional | $111.78 | $111.78 | $111.78 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $1,837.51 | $1,837.51 | $1,837.51 |