| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $486.54 | $486.54 | $1,033.90 | |
Aetna
| Professional | $473.77 | $473.77 | $473.77 | |
Anthem BCBS
| Professional | $194.62 | $194.62 | $316.25 | |
Harvard Pilgrim
| Professional | $486.54 | $486.54 | $491.41 | |
Martin's Point
| Facility | $486.54 | $486.54 | $788.20 | |
Martin's Point
| Professional | $473.77 | $473.77 | $486.54 | |
United
| Professional | $291.92 | $291.92 | $729.81 |