| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,650.00 | $7,629.00 | $13,387.00 | |
Aetna
| Facility | 50 | $4,600.58 | $9,884.15 | $12,570.00 |
Anthem BCBS
| Facility | $2,826.00 | $4,945.58 | $12,905.00 | |
Health New England
| Facility | $1,797.62 | $3,901.88 | $4,339.38 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |