| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $200.00 | $200.00 | $425.00 | |
Aetna
| Professional | $128.00 | $128.00 | $128.00 | |
Anthem BCBS
| Professional | $80.00 | $80.00 | $130.00 | |
Harvard Pilgrim
| Professional | $200.00 | $200.00 | $202.00 | |
Martin's Point
| Facility | $200.00 | $200.00 | $324.00 | |
Martin's Point
| Professional | $128.00 | $128.00 | $200.00 | |
United
| Professional | $102.00 | $120.00 | $300.00 |