| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Anthem BCBS
| Professional | $5.59 | $5.59 | $5.82 | |
Harvard Pilgrim
| Professional | $3.71 | $3.71 | $3.71 | |
United
| Professional | $3.71 | $3.71 | $3.71 |