| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Anthem BCBS
| Professional | $126.41 | $126.41 | $126.41 | |
Health New England
| Professional | $232.77 | $232.77 | $232.77 |