| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $81.28 | $81.28 | $81.28 | |
Aetna
| Professional | $48.98 | $81.28 | $95.50 | |
Anthem BCBS
| Professional | $28.84 | $33.88 | $43.65 | |
Harvard Pilgrim
| Professional | $85.11 | $120.23 | $229.09 | |
Martin's Point
| Professional | $50.12 | $81.28 | $95.50 | |
United
| Professional | $77.62 | $107.15 | $208.93 |