| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $891.25 | $891.25 | $891.25 | |
Aetna
| Professional | $169.82 | $223.87 | $309.03 | |
Anthem BCBS
| Professional | $190.55 | $190.55 | $323.59 | |
Harvard Pilgrim
| Professional | $239.88 | $302.00 | $575.44 | |
Martin's Point
| Facility | $891.25 | $891.25 | $891.25 | |
Martin's Point
| Professional | $173.78 | $229.09 | $389.05 | |
United
| Professional | $162.18 | $257.04 | $562.34 |