| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $146.74 | $146.74 | $508.74 | |
Aetna
| Professional | $146.74 | $146.74 | $508.74 | |
Anthem BCBS
| Professional | $157.38 | $157.38 | $650.00 | |
Cigna
| Professional | $159.00 | $159.00 | $159.00 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $93.02 | $93.02 | $93.02 |