| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.45 | $99.45 | $119.34 | |
Aetna
| Professional | $58.28 | $99.45 | $106.19 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Harvard Pilgrim
| Professional | $80.56 | $80.56 | $200.06 | |
United
| Professional | $80.56 | $80.56 | $80.56 |