| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.72 | $131.72 | $131.72 | |
Aetna
| Professional | $106.45 | $131.72 | $132.65 | |
Anthem BCBS
| Professional | $15.00 | $15.00 | $43.00 | |
Hometown Health
| Professional | $130.00 | $350.00 | $493.00 |