| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.10 | $17.10 | $17.10 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $203.99 | $203.99 | $203.99 | |
Harvard Pilgrim
| Professional | $51.42 | $51.42 | $51.42 | |
Martin's Point
| Professional | $17.10 | $17.10 | $17.10 |