| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $194.98 | |
Aetna
| Professional | $144.54 | $173.78 | $173.78 | |
Anthem BCBS
| Professional | $30.20 | $30.20 | $30.20 | |
Harvard Pilgrim
| Professional | $53.70 | $53.70 | $81.28 | |
United
| Professional | $53.70 | $53.70 | $53.70 |