| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,862.09 | $4,897.79 | $9,549.93 | |
Aetna
| Facility | 50 | $1,318.26 | $5,495.41 | $9,772.37 |
Anthem BCBS
| Facility | $4,786.30 | $13,803.84 | $19,952.62 | |
Health New England
| Facility | $1,288.25 | $1,288.25 | $1,288.25 | |
United
| Facility | $5,754.40 | $8,709.64 | $11,748.98 |