| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $385.57 | $385.57 | $462.68 | |
Aetna
| Professional | $176.65 | $385.57 | $416.40 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Harvard Pilgrim
| Professional | $128.47 | $128.47 | $319.02 | |
United
| Professional | $128.47 | $128.47 | $128.47 |