| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,560.00 | $7,629.00 | $12,992.67 | |
Aetna
| Facility | 50 | $6,196.20 | $9,728.03 | $12,570.00 |
Anthem BCBS
| Facility | $2,826.00 | $4,945.58 | $12,905.00 | |
Health New England
| Facility | $618.36 | $618.36 | $618.36 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |