| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $190.55 | $190.55 | $190.55 | |
Anthem BCBS
| Facility | $263.03 | $501.19 | $831.76 | |
Anthem BCBS
| Professional | $169.82 | $173.78 | $194.98 | |
Cigna
| Facility | $190.55 | $190.55 | $190.55 | |
Cigna
| Professional | $190.55 | $190.55 | $190.55 | |
Harvard Pilgrim
| Professional | $190.55 | $316.23 | $363.08 | |
United
| Professional | $169.82 | $190.55 | $204.17 |