| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,698.24 | $3,890.45 | $9,772.37 | |
Anthem BCBS
| Facility | $5,623.41 | $15,135.61 | $23,988.33 | |
Harvard Pilgrim
| Facility | $10,000.00 | $10,000.00 | $10,000.00 | |
United
| Facility | $10,000.00 | $10,000.00 | $10,000.00 |