| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $147.91 | |
Aetna
| Professional | $131.83 | $147.91 | $177.83 | |
Anthem BCBS
| Professional | $147.91 | $190.55 | $288.40 | |
Cigna
| Professional | $190.55 | $190.55 | $190.55 | |
Hometown Health
| Professional | $0.87 | $199.53 | $288.40 | |
Hometown Health
| Professional | $0.87 | $218.78 | $338.84 | |
Select Health
| Professional | $154.88 | $223.87 | $263.03 | |
United
| Professional | $147.91 | $208.93 | $323.59 |