| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $855.25 | $855.25 | $855.25 | |
Aetna
| Professional | $855.25 | $855.25 | $855.25 | |
Anthem BCBS
| Professional | $8.01 | $8.01 | $8.01 | |
Harvard Pilgrim
| Professional | $4,930.88 | $4,930.88 | $4,930.88 | |
Martin's Point
| Professional | $855.25 | $855.25 | $855.25 |