| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $158.49 | $158.49 | $158.49 |
Aetna
| Professional | $169.82 | $204.17 | $302.00 | |
Anthem BCBS
| Professional | $169.82 | $213.80 | $380.19 | |
Cigna
| Professional | $114.82 | $281.84 | $457.09 | |
Harvard Pilgrim
| Professional | $223.87 | $316.23 | $616.60 | |
Martin's Point
| Professional | $169.82 | $223.87 | $512.86 | |
United
| Professional | $194.98 | $281.84 | $467.74 |