| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.00 | $51.00 | $51.00 | |
Anthem BCBS
| Professional | $111.03 | $121.83 | $121.83 | |
Harvard Pilgrim
| Professional | $865.93 | $865.93 | $865.93 | |
Martin's Point
| Professional | $51.00 | $51.00 | $51.00 | |
United
| Professional | $117.12 | $117.12 | $117.12 |