| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $512.86 | $512.86 | $512.86 | |
Aetna
| Professional | $141.25 | $186.21 | $251.19 | |
Ambetter
| Professional | 25 | $128.82 | $147.91 | $173.78 |
Anthem BCBS
| Professional | $147.91 | $173.78 | $309.03 | |
Cigna
| Professional | $165.96 | $165.96 | $295.12 | |
Harvard Pilgrim
| Professional | $158.49 | $245.47 | $588.84 | |
United
| Professional | $162.18 | $251.19 | $467.74 |