| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.65 | $700.00 | $700.00 | |
Aetna
| Professional | $87.65 | $700.00 | $700.00 | |
Anthem BCBS
| Professional | $54.22 | $54.22 | $73.08 | |
Hometown Health
| Professional | $200.00 | $400.00 | $493.00 | |
Hometown Health
| Facility | $62.01 | $62.01 | $62.01 |