| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $171.15 | $171.15 | $892.73 | |
Aetna
| Professional | $171.15 | $171.15 | $392.08 | |
Anthem BCBS
| Professional | $379.73 | $387.85 | $650.00 | |
Cigna
| Professional | $159.00 | $445.60 | $533.88 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $438.61 | $438.61 | $438.61 |