| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $380.19 | $1,905.46 | $9,772.37 | |
Cigna
| Facility | $5,495.41 | $5,495.41 | $5,495.41 | |
Harvard Pilgrim
| Facility | $7,413.10 | $7,413.10 | $7,413.10 | |
United
| Facility | $7,413.10 | $7,413.10 | $7,413.10 | |
Well Sense
| Facility | $186.21 | $186.21 | $302.00 | |
Well Sense
| Facility | 62 | $107.15 | $107.15 | $107.15 |