| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $125.89 | $125.89 | $218.78 | |
Anthem BCBS
| Facility | $0.03 | $0.03 | $0.03 | |
Anthem BCBS
| Professional | $134.90 | $134.90 | $134.90 | |
Harvard Pilgrim
| Professional | $125.89 | $144.54 | $162.18 | |
Martin's Point
| Professional | $125.89 | $125.89 | $234.42 | |
United
| Professional | $125.89 | $147.91 | $223.87 |