| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $141.25 | $281.84 | |
Aetna
| Professional | $125.89 | $125.89 | $125.89 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.04 | |
Anthem BCBS
| Professional | $134.90 | $134.90 | $154.88 | |
Harvard Pilgrim
| Professional | $125.89 | $208.93 | $239.88 | |
United
| Professional | $125.89 | $147.91 | $169.82 |