| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.81 | $39.81 | $39.81 | |
Cigna
| Professional | $31.62 | $31.62 | $31.62 | |
Harvard Pilgrim
| Professional | $39.81 | $39.81 | $54.95 | |
United
| Professional | $33.88 | $39.81 | $58.88 |