| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,398.83 | $5,370.32 | $15,848.93 | |
Aetna
| Facility | 50 | $2,137.96 | $4,073.80 | $25,118.86 |
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 |