| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.33 | $120.23 | $131.83 | |
Aetna
| Professional | $5.01 | $10.96 | $102.33 | |
Anthem BCBS
| Professional | $125.89 | $125.89 | $125.89 | |
Harvard Pilgrim
| Professional | $125.89 | $125.89 | $125.89 | |
United
| Professional | $125.89 | $125.89 | $125.89 |