| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $912.01 | $2,398.83 | $9,772.37 | |
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 | $173.78 | $173.78 | $275.42 |