| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $165.27 | $165.27 | $165.27 | |
Anthem BCBS
| Facility | $491.36 | $491.36 | $491.36 | |
Anthem BCBS
| Professional | $158.91 | $158.91 | $158.91 | |
Cigna
| Facility | $152.91 | $158.91 | $179.91 | |
Cigna
| Professional | $158.91 | $158.91 | $158.91 | |
Harvard Pilgrim
| Professional | $158.91 | $158.91 | $192.45 | |
Martin's Point
| Professional | $158.91 | $165.27 | $165.27 | |
United
| Professional | $63.57 | $158.91 | $238.38 |