| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.87 | $196.87 | $196.87 | |
Aetna
| Professional | $84.07 | $196.87 | $303.98 | |
Anthem BCBS
| Professional | $174.38 | $197.37 | $198.01 | |
Harvard Pilgrim
| Professional | $260.10 | $300.94 | $461.65 | |
Martin's Point
| Professional | $84.07 | $196.87 | $303.98 | |
United
| Professional | $178.44 | $280.33 | $404.72 |