| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.25 | $123.25 | $123.25 | |
Aetna
| Professional | $117.45 | $123.25 | $123.25 | |
Anthem BCBS
| Professional | $33.75 | $45.00 | $55.87 | |
ConnectiCare
| Professional | $80.54 | $80.54 | $80.54 |