| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $24.95 | $24.95 | $24.95 | |
Anthem BCBS
| Facility | $0.03 | $0.03 | $0.03 | |
Anthem BCBS
| Professional | $27.00 | $27.00 | $27.00 | |
Cigna
| Facility | $27.68 | $27.68 | $27.68 | |
Cigna
| Professional | $27.68 | $27.68 | $27.68 | |
Harvard Pilgrim
| Professional | $24.95 | $28.87 | $44.28 | |
Martin's Point
| Professional | $24.95 | $24.95 | $24.95 | |
United
| Professional | $28.87 | $29.35 | $44.03 |