| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $99.28 | $99.28 | $99.28 | |
Anthem BCBS
| Facility | $880.93 | $1,216.83 | $1,997.06 | |
Anthem BCBS
| Professional | $103.77 | $122.09 | $152.94 | |
Harvard Pilgrim
| Professional | $109.23 | $126.38 | $237.12 | |
Martin's Point
| Professional | $99.28 | $99.28 | $99.28 | |
United
| Professional | $86.76 | $136.97 | $222.57 |