| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.60 | $61.60 | $61.60 | |
Aetna
| Professional | $61.60 | $61.60 | $67.70 | |
Anthem BCBS
| Professional | $104.97 | $182.00 | $219.96 | |
Harvard Pilgrim
| Professional | $74.98 | $92.62 | $156.56 | |
Martin's Point
| Professional | $61.60 | $61.60 | $67.70 | |
United
| Professional | $72.14 | $97.95 | $144.57 |