| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.84 | $82.84 | $82.84 | |
Aetna
| Professional | $80.62 | $82.84 | $96.00 | |
Anthem BCBS
| Professional | $33.32 | $42.57 | $51.13 | |
Harvard Pilgrim
| Professional | $84.44 | $104.31 | $176.32 | |
Martin's Point
| Professional | $80.62 | $82.84 | $96.00 | |
United
| Professional | $80.78 | $116.77 | $214.12 |