| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $373.49 | $373.49 | $373.49 | |
Aetna
| Professional | $285.77 | $285.77 | $285.77 | |
Harvard Pilgrim
| Professional | $2,059.69 | $2,059.69 | $2,059.69 | |
Martin's Point
| Facility | $373.49 | $373.49 | $373.49 | |
Martin's Point
| Professional | $285.77 | $285.77 | $285.77 |