| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,183.00 | $4,667.77 | $10,492.00 | |
Aetna
| Facility | 50 | $3,288.60 | $3,619.00 | $3,619.00 |
Anthem BCBS
| Facility | $7,483.00 | $12,145.00 | $17,933.32 | |
Health New England
| Facility | $159.25 | $159.25 | $159.25 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |