| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $489.78 | $1,479.11 | $2,344.23 |
Aetna
| Professional | QZ | $524.81 | $676.08 | $1,698.24 |
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 |