| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.00 | $107.00 | $227.38 | |
Aetna
| Professional | $86.67 | $86.67 | $86.67 | |
Anthem BCBS
| Professional | $42.80 | $47.08 | $371.66 | |
Harvard Pilgrim
| Professional | $107.00 | $107.00 | $108.07 | |
Martin's Point
| Facility | $107.00 | $107.00 | $173.34 | |
Martin's Point
| Professional | $86.67 | $86.67 | $107.00 | |
United
| Professional | $64.20 | $64.20 | $160.50 |