| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.34 | $212.34 | $212.34 | |
Aetna
| Professional | $212.34 | $212.34 | $212.34 | |
Anthem BCBS
| Professional | $26.28 | $26.28 | $29.17 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $149.37 | $149.37 | $149.37 |