| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $142.75 | $142.75 | $152.94 | |
Aetna
| Professional | $125.08 | $142.75 | $152.94 | |
Anthem BCBS
| Professional | $167.49 | $167.49 | $211.74 | |
Hometown Health
| Professional | $200.00 | $350.00 | $425.00 | |
Hometown Health
| Facility | $1,837.51 | $1,837.51 | $1,837.51 |