| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.49 | $56.49 | $56.49 | |
Aetna
| Professional | $46.20 | $52.72 | $68.52 | |
Anthem BCBS
| Professional | $60.56 | $60.56 | $92.00 | |
Hometown Health
| Professional | $175.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $1,837.51 | $1,837.51 | $1,837.51 |