| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.34 | $76.34 | $4,842.26 | |
Aetna
| Professional | $52.85 | $74.17 | $76.34 | |
Anthem BCBS
| Professional | $73.54 | $81.00 | $105.02 | |
Harvard Pilgrim
| Professional | $87.18 | $172.95 | $287.18 |