| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,398.83 | $4,570.88 | $14,791.08 | |
Anthem BCBS
| Facility | $5,011.87 | $5,623.41 | $8,912.51 | |
Harvard Pilgrim
| Facility | $12,302.69 | $12,302.69 | $12,302.69 | |
United
| Facility | $12,302.69 | $12,302.69 | $12,302.69 |