| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Ambetter
| Facility | $4,500.00 | $4,500.00 | $4,500.00 | |
Anthem BCBS
| Facility | $5,055.95 | $17,825.91 | $39,427.85 | |
Harvard Pilgrim
| Facility | $17,570.83 | $28,426.80 | $41,762.25 | |
United
| Facility | $23,151.22 | $23,151.22 | $40,289.49 |