| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.18 | $2,488.94 | $4,127.27 | |
Aetna
| Professional | $690.18 | $690.18 | $961.51 | |
Anthem BCBS
| Professional | $30.00 | $630.32 | $630.32 | |
Cigna
| Professional | $240.52 | $240.52 | $240.52 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $746.73 | $746.73 | $746.73 |