| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $51.29 | $51.29 | $75.86 | |
Anthem BCBS
| Professional | $100.00 | $123.03 | $134.90 | |
Harvard Pilgrim
| Professional | $870.96 | $870.96 | $870.96 | |
Martin's Point
| Professional | $51.29 | $51.29 | $75.86 | |
United
| Professional | $117.49 | $117.49 | $891.25 |