| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $171.96 | $171.96 | $332.76 | |
Aetna
| Professional | $134.90 | $171.96 | $332.76 | |
Anthem BCBS
| Professional | $214.49 | $317.22 | $650.00 | |
Cigna
| Professional | $159.00 | $159.00 | $159.00 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $267.94 | $267.94 | $267.94 |