| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $144.54 | $346.74 | |
Aetna
| Professional | $128.82 | $177.83 | $275.42 | |
Aetna
| Professional | 25 | $138.04 | $138.04 | $138.04 |
Anthem BCBS
| Professional | $134.90 | $223.87 | $288.40 | |
Cigna
| Professional | $114.82 | $281.84 | $398.11 | |
Harvard Pilgrim
| Professional | $199.53 | $234.42 | $281.84 | |
Martin's Point
| Professional | $131.83 | $173.78 | $269.15 | |
Martin's Point
| Professional | 25 | $138.04 | $138.04 | $138.04 |
United
| Professional | $158.49 | $234.42 | $302.00 |