| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $632.99 | $873.09 | $873.09 | |
Anthem BCBS
| Professional | $708.00 | $1,148.16 | $1,350.82 | |
Harvard Pilgrim
| Professional | $959.67 | $1,110.33 | $1,703.32 | |
Martin's Point
| Professional | $632.99 | $873.09 | $873.09 |