| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $707.95 | $1,380.38 | $2,290.87 |
Aetna
| Professional | QZ | $234.42 | $812.83 | $1,230.27 |
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 |