| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Harvard Pilgrim
| Professional | $134.90 | $165.96 | $269.15 |
Unspecified Adjunctive Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Harvard Pilgrim
| Professional | $134.90 | $165.96 | $269.15 |