| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.97 | $121.97 | $121.97 | |
Aetna
| Professional | $55.53 | $55.53 | $55.54 | |
Harvard Pilgrim
| Professional | $226.86 | $226.86 | $226.86 | |
Martin's Point
| Facility | $121.97 | $121.97 | $121.97 | |
Martin's Point
| Professional | $55.53 | $55.53 | $55.54 |