| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.39 | $2.39 | $2.39 | |
Aetna
| Professional | $0.80 | $2.39 | $2.39 | |
Anthem BCBS
| Professional | $59.00 | $59.00 | $59.00 | |
Health New England
| Professional | $36.92 | $36.92 | $36.92 |