| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $44.67 | $44.67 | $213.80 | |
Harvard Pilgrim
| Professional | $912.01 | $912.01 | $912.01 | |
Martin's Point
| Professional | $44.67 | $44.67 | $144.54 | |
United
| Professional | $912.01 | $912.01 | $912.01 |