| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $139.75 | $139.75 | $167.70 | |
Aetna
| Professional | $13.00 | $139.75 | $139.75 | |
Anthem BCBS
| Professional | $6.68 | $6.68 | $6.68 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Harvard Pilgrim
| Professional | $69.69 | $77.05 | $101.71 |