| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,737.80 | $5,370.32 | $22,387.21 | |
Anthem BCBS
| Facility | $4,897.79 | $5,495.41 | $8,128.31 | |
Harvard Pilgrim
| Facility | $12,302.69 | $12,302.69 | $12,302.69 | |
United
| Facility | $12,302.69 | $12,302.69 | $12,302.69 |