| 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 | $275.42 | $275.42 | $354.81 | |
Harvard Pilgrim
| Professional | $239.88 | $316.23 | $602.56 | |
Martin's Point
| Facility | $891.25 | $891.25 | $891.25 | |
Martin's Point
| Professional | $173.78 | $229.09 | $389.05 | |
United
| Professional | $288.40 | $457.09 | $954.99 |