| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.78 | $173.78 | $281.84 | |
Aetna
| Professional | $95.50 | $131.83 | $169.82 | |
Anthem BCBS
| Facility | $169.82 | $204.17 | $602.56 | |
Anthem BCBS
| Professional | $69.18 | $114.82 | $426.58 | |
Cigna
| Facility | $398.11 | $398.11 | $398.11 | |
Harvard Pilgrim
| Professional | $173.78 | $173.78 | $208.93 | |
Martin's Point
| Facility | $173.78 | $173.78 | $173.78 | |
Martin's Point
| Professional | $95.50 | $134.90 | $169.82 | |
United
| Professional | $104.71 | $173.78 | $263.03 |