| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $152.78 | $152.78 | $183.34 | |
Aetna
| Professional | $152.78 | $251.12 | $251.12 | |
Anthem BCBS
| Professional | $172.19 | $172.19 | $172.19 | |
Harvard Pilgrim
| Professional | $588.17 | $945.40 | $1,387.54 |