| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $1,819.70 | $9,772.37 | |
Harvard Pilgrim
| Facility | $7,413.10 | $7,413.10 | $7,413.10 | |
United
| Facility | $7,413.10 | $7,413.10 | $7,413.10 | |
Well Sense
| Facility | $72.44 | $72.44 | $89.13 |