| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $468.33 | $468.33 | $995.20 | |
Aetna
| Professional | $379.35 | $379.35 | $379.35 | |
Anthem BCBS
| Professional | $187.33 | $187.33 | $304.41 | |
Harvard Pilgrim
| Professional | $468.33 | $468.33 | $473.01 | |
Martin's Point
| Facility | $468.33 | $468.33 | $758.70 | |
Martin's Point
| Professional | $379.35 | $379.35 | $468.33 | |
United
| Professional | $234.17 | $281.00 | $702.50 |