| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $2,398.83 | $14,125.38 | |
Harvard Pilgrim
| Facility | $10,000.00 | $10,000.00 | $10,000.00 | |
United
| Facility | $10,000.00 | $10,000.00 | $10,000.00 | |
Well Sense
| Facility | $120.23 | $120.23 | $194.98 |