| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $706.25 | $706.25 | $706.25 | |
Anthem BCBS
| Professional | $282.50 | $423.75 | $459.06 | |
Harvard Pilgrim
| Professional | $706.25 | $706.25 | $706.25 | |
Martin's Point
| Professional | $706.25 | $706.25 | $706.25 | |
United
| Professional | $423.75 | $706.25 | $1,235.94 |