| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.69 | $104.69 | $104.69 | |
Aetna
| Professional | $102.23 | $104.69 | $104.69 | |
Anthem BCBS
| Professional | $0.03 | $50.63 | $50.63 | |
ConnectiCare
| Professional | $62.16 | $62.16 | $62.16 |