| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $287.56 | $287.56 | $287.56 | |
Harvard Pilgrim
| Professional | $3,619.02 | $3,619.02 | $3,619.02 | |
Martin's Point
| Professional | $287.56 | $287.56 | $287.56 | |
United
| Professional | $3,619.02 | $3,619.02 | $3,629.70 |