| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $275.38 | $275.38 | $275.38 | |
Aetna
| Professional | $275.37 | $300.00 | $330.00 | |
Anthem BCBS
| Professional | $95.88 | $95.88 | $123.73 | |
Harvard Pilgrim
| Professional | $131.74 | $162.74 | $275.08 | |
Martin's Point
| Professional | $275.37 | $300.00 | $330.00 |