| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,905.46 | $5,370.32 | $22,387.21 | |
Anthem BCBS
| Facility | $35,481.34 | $39,810.72 | $39,810.72 | |
Harvard Pilgrim
| Facility | $12,589.25 | $12,589.25 | $12,589.25 | |
United
| Facility | $12,589.25 | $12,589.25 | $12,589.25 |