| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $616.60 | $616.60 | |
Aetna
| Professional | $169.82 | $229.09 | $302.00 | |
Ambetter
| Professional | 25 | $245.47 | $245.47 | $257.04 |
Anthem BCBS
| Professional | $208.93 | $251.19 | $436.52 | |
Cigna
| Professional | $234.42 | $239.88 | $416.87 | |
Harvard Pilgrim
| Professional | $229.09 | $295.12 | $851.14 | |
United
| Professional | $229.09 | $309.03 | $575.44 |