| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.33 | $93.33 | $173.59 | |
Aetna
| Professional | $91.66 | $93.33 | $120.06 | |
Fallon Health
| Facility | $83.43 | $4,618.00 | $9,239.00 | |
Harvard Pilgrim
| Professional | $214.02 | $266.25 | $341.80 |