| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $561.60 | $864.03 | $864.04 | |
Aetna
| Professional | $70.00 | $864.04 | $864.04 | |
Cigna
| Professional | $348.00 | $348.00 | $348.00 | |
Harvard Pilgrim
| Professional | $342.39 | $378.55 | $499.68 |