| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $301.35 | $301.35 | $640.37 | |
Aetna
| Professional | $301.35 | $301.35 | $301.35 | |
Anthem BCBS
| Professional | $120.54 | $120.54 | $195.87 | |
Harvard Pilgrim
| Professional | $301.35 | $361.05 | $534.87 | |
Martin's Point
| Facility | $301.35 | $301.35 | $488.19 | |
Martin's Point
| Professional | $301.35 | $301.35 | $301.35 | |
United
| Professional | $153.69 | $180.81 | $527.36 |