| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.57 | $104.57 | $112.04 | |
Aetna
| Professional | $93.21 | $104.57 | $112.04 | |
Anthem BCBS
| Professional | $120.08 | $120.08 | $120.08 | |
Hometown Health
| Professional | $200.00 | $425.00 | $757.14 | |
Hometown Health
| Facility | $688.31 | $1,637.08 | $1,637.08 |