| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $382.90 | $382.90 | $410.25 | |
Aetna
| Professional | $306.20 | $382.90 | $410.25 | |
Anthem BCBS
| Professional | $439.50 | $439.50 | $634.87 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $1,837.51 | $1,837.51 | $1,837.51 |