| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $190.55 | $190.55 | |
Aetna
| Professional | $173.78 | $194.98 | $229.09 | |
Anthem BCBS
| Professional | $144.54 | $218.78 | $218.78 | |
Hometown Health
| Facility | $691.83 | $691.83 | $691.83 |