| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $109.08 | $109.08 | $109.08 | |
Anthem BCBS
| Professional | $129.72 | $169.92 | $219.90 | |
Harvard Pilgrim
| Professional | $143.44 | $165.97 | $254.61 | |
Martin's Point
| Professional | $109.08 | $109.08 | $109.08 | |
United
| Professional | $126.26 | $154.96 | $229.89 |