| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $921.20 | $4,870.22 | $8,031.00 | |
Aetna
| Facility | 52 | $167.73 | $173.98 | $394.05 |
Anthem BCBS
| Facility | $3,034.00 | $5,125.66 | $9,678.00 | |
Health New England
| Facility | $1,956.28 | $1,956.28 | $2,756.58 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |