| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $656.25 | $656.25 | $656.25 | |
Anthem BCBS
| Professional | $211.15 | $211.15 | $608.58 | |
Harvard Pilgrim
| Professional | $15,708.41 | $15,708.41 | $15,708.41 | |
Martin's Point
| Professional | $656.25 | $656.25 | $754.68 | |
United
| Professional | $249.12 | $249.12 | $249.12 |