| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $826.50 | $826.50 | $826.50 | |
Aetna
| Professional | $83.00 | $826.50 | $826.50 | |
Anthem BCBS
| Professional | $14.00 | $14.00 | $25.00 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 |