| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,059.21 | $1,059.21 | $1,059.21 | |
Aetna
| Professional | $1,059.21 | $1,059.21 | $1,059.21 | |
Cigna
| Facility | $1,437.21 | $8,062.55 | $13,588.20 | |
Fallon Health
| Facility | $83.43 | $4,618.00 | $9,239.00 | |
Harvard Pilgrim
| Professional | $2,186.15 | $2,679.95 | $3,341.96 |