| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,196.00 | $6,015.00 | $9,479.00 | |
Aetna
| Facility | 50 | $1,324.43 | $5,491.20 | $9,881.43 |
Anthem BCBS
| Facility | $3,034.00 | $5,125.66 | $12,905.00 | |
Health New England
| Facility | $1,300.61 | $1,300.61 | $1,300.61 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |