| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.05 | $112.05 | $134.46 | |
Aetna
| Professional | $106.77 | $112.05 | $112.05 | |
Anthem BCBS
| Professional | $28.50 | $28.50 | $28.50 | |
Cigna
| Facility | $112.05 | $112.05 | $112.05 | |
Cigna
| Professional | $112.05 | $112.05 | $112.05 | |
Harvard Pilgrim
| Professional | $112.05 | $148.66 | $185.83 |