| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.77 | $163.77 | $196.52 | |
Aetna
| Professional | $143.75 | $163.77 | $175.28 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Harvard Pilgrim
| Professional | $53.35 | $53.35 | $132.47 | |
United
| Professional | $53.35 | $53.35 | $53.35 |