| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.34 | $4,305.00 | $8,031.00 | |
Aetna
| Facility | 52 | $60.56 | $62.49 | $113.72 |
Anthem BCBS
| Facility | $2,826.00 | $4,634.53 | $7,588.00 | |
Health New England
| Facility | $3,912.56 | $3,912.56 | $3,912.56 | |
United
| Facility | $1,347.00 | $3,978.00 | $6,832.00 |