| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.92 | $65.92 | $105.34 | |
Aetna
| Professional | $65.92 | $105.34 | $209.49 | |
Aetna
| Professional | 52 | $32.96 | $52.67 | $52.67 |
Anthem BCBS
| Professional | $82.95 | $129.54 | $202.69 | |
Cigna
| Professional | $91.07 | $162.47 | $261.35 | |
Harvard Pilgrim
| Professional | $105.11 | $164.47 | $276.89 | |
Martin's Point
| Professional | $65.92 | $105.34 | $209.49 | |
Martin's Point
| Professional | 52 | $32.96 | $32.96 | $52.67 |
United
| Professional | $124.51 | $186.56 | $272.36 |