| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.25 | $123.25 | $147.90 | |
Aetna
| Professional | $117.45 | $123.25 | $123.25 | |
Anthem BCBS
| Professional | $45.00 | $45.00 | $45.00 | |
Cigna
| Facility | $123.25 | $123.25 | $123.25 | |
Harvard Pilgrim
| Professional | $123.25 | $163.53 | $204.41 |