| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,238.72 | $2,754.23 | $11,220.18 | |
Aetna
| Facility | 50 | $4,265.80 | $4,265.80 | $4,265.80 |
Anthem BCBS
| Facility | $10,471.29 | $11,481.54 | $15,488.17 | |
Harvard Pilgrim
| Facility | $12,302.69 | $12,302.69 | $12,302.69 | |
United
| Facility | $12,302.69 | $12,302.69 | $12,302.69 |