| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.00 | $19.63 | $19.63 | |
Anthem BCBS
| Professional | $56.67 | $63.32 | $63.32 | |
Harvard Pilgrim
| Professional | $98.50 | $126.86 | $194.62 | |
Martin's Point
| Professional | $8.00 | $19.63 | $19.63 | |
United
| Professional | $23.33 | $29.86 | $133.44 |