| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $700.00 | $700.00 | $700.00 | |
Anthem BCBS
| Professional | $69.39 | $73.08 | $91.55 | |
Harvard Pilgrim
| Professional | $73.08 | $73.08 | $73.08 | |
Martin's Point
| Professional | $700.00 | $700.00 | $700.00 |