| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $274.83 | $274.83 | $584.01 | |
Aetna
| Professional | $274.83 | $274.83 | $274.83 | |
Anthem BCBS
| Professional | $109.93 | $109.93 | $178.63 | |
Harvard Pilgrim
| Professional | $274.83 | $329.27 | $487.80 | |
Martin's Point
| Facility | $274.83 | $274.83 | $445.23 | |
Martin's Point
| Professional | $274.83 | $274.83 | $274.83 | |
United
| Professional | $164.90 | $164.90 | $480.95 |