| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.10 | $17.10 | $20.52 | |
Aetna
| Professional | $17.10 | $17.10 | $17.10 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Harvard Pilgrim
| Professional | $51.42 | $62.81 | $62.81 |