| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $123.03 | $123.03 | |
Aetna
| Professional | $48.98 | $50.12 | $54.95 | |
Harvard Pilgrim
| Professional | $229.09 | $229.09 | $229.09 | |
Martin's Point
| Facility | $123.03 | $123.03 | $123.03 | |
Martin's Point
| Professional | $48.98 | $54.95 | $54.95 | |
United
| Professional | $190.55 | $190.55 | $229.09 |