| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.96 | $165.96 | $165.96 | |
Aetna
| Professional | $41.69 | $57.54 | $75.86 | |
Ambetter
| Professional | $53.70 | $53.70 | $53.70 | |
Ambetter
| Professional | 25 | $43.65 | $43.65 | $43.65 |
Anthem BCBS
| Professional | $45.71 | $56.23 | $100.00 | |
Cigna
| Professional | $53.70 | $53.70 | $91.20 | |
Harvard Pilgrim
| Professional | $50.12 | $72.44 | $186.21 | |
United
| Professional | $50.12 | $77.62 | $141.25 |