| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $149.83 | $149.83 | $164.81 | |
Anthem BCBS
| Facility | $454.57 | $454.57 | $454.57 | |
Anthem BCBS
| Professional | $149.96 | $149.96 | $149.96 | |
Cigna
| Facility | $164.66 | $164.66 | $164.66 | |
Cigna
| Professional | $164.66 | $164.66 | $164.66 | |
Harvard Pilgrim
| Professional | $149.83 | $173.35 | $265.93 | |
Martin's Point
| Professional | $149.83 | $149.83 | $216.59 | |
United
| Professional | $124.97 | $147.02 | $257.29 |