| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $252.64 | $252.64 | $252.64 | |
Aetna
| Professional | $252.64 | $252.64 | $252.64 | |
Anthem BCBS
| Professional | $31.94 | $31.94 | $35.45 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $346.77 | $346.77 | $346.77 |