| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $707.95 | $1,348.96 | $2,398.83 |
Aetna
| Professional | QZ | $316.23 | $1,047.13 | $1,737.80 |
AllWays Health Partners
| Facility | QK | $52.48 | $52.48 | $52.48 |
AllWays Health Partners
| Facility | QX | $52.48 | $52.48 | $52.48 |
AllWays Health Partners
| Facility | QY | $52.48 | $52.48 | $52.48 |
Mass General Brigham
| Facility | QK | $52.48 | $52.48 | $52.48 |
Mass General Brigham
| Facility | QX | $52.48 | $52.48 | $52.48 |
Mass General Brigham
| Facility | QY | $52.48 | $52.48 | $52.48 |