| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.68 | $129.68 | $138.94 | |
Aetna
| Professional | $129.68 | $129.68 | $138.94 | |
Anthem BCBS
| Professional | $110.40 | $148.81 | $148.81 | |
Hometown Health
| Professional | $200.00 | $425.00 | $757.14 | |
Hometown Health
| Facility | $688.31 | $1,637.08 | $1,637.08 |