| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,089.30 | $5,011.87 | $9,772.37 | |
Anthem BCBS
| Facility | $5,623.41 | $18,197.01 | $28,840.32 | |
Harvard Pilgrim
| Facility | $691.83 | $4,265.80 | $9,549.93 | |
United
| Facility | $691.83 | $4,265.80 | $9,549.93 | |
Well Sense
| Facility | $1,000.00 | $1,445.44 | $1,698.24 |