| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.10 | $17.10 | $77.67 | |
Aetna
| Professional | $17.10 | $17.10 | $77.67 | |
Anthem BCBS
| Professional | $30.00 | $66.45 | $66.45 | |
Cigna
| Professional | $159.00 | $159.00 | $159.00 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $54.08 | $54.08 | $54.08 |