| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,475.20 | $5,475.20 | $11,634.80 | |
Aetna
| Professional | $583.20 | $583.20 | $583.20 | |
Anthem BCBS
| Professional | $2,190.08 | $2,190.08 | $3,558.88 | |
Harvard Pilgrim
| Professional | $5,475.20 | $5,475.20 | $5,529.95 | |
Martin's Point
| Facility | $5,475.20 | $5,475.20 | $8,869.82 | |
Martin's Point
| Professional | $583.20 | $583.20 | $5,475.20 | |
United
| Professional | $2,792.35 | $3,285.12 | $9,581.60 |