| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.23 | $114.23 | $114.23 | |
Aetna
| Professional | $102.90 | $114.23 | $163.97 | |
Anthem BCBS
| Professional | $107.95 | $129.97 | $192.92 | |
Cigna
| Professional | $121.20 | $166.36 | $254.08 | |
Harvard Pilgrim
| Professional | $110.36 | $136.33 | $230.45 | |
Martin's Point
| Professional | $102.90 | $116.93 | $162.69 | |
United
| Professional | $122.00 | $156.32 | $236.48 |