| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.53 | $127.53 | $136.63 | |
Aetna
| Professional | $112.06 | $127.53 | $136.63 | |
Anthem BCBS
| Professional | $146.38 | $146.38 | $171.55 | |
Hometown Health
| Professional | $200.00 | $425.00 | $446.29 | |
Hometown Health
| Facility | $405.72 | $777.59 | $777.59 |