| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $89.13 | $93.33 | $97.72 | |
Harvard Pilgrim
| Professional | $407.38 | $407.38 | $407.38 | |
Martin's Point
| Professional | $89.13 | $93.33 | $128.82 | |
United
| Professional | $87.10 | $87.10 | $407.38 |