| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $838.72 | $3,083.85 | $4,069.97 |
AllWays Health Partners
| Facility | QK | $39.50 | $39.50 | $39.50 |
AllWays Health Partners
| Facility | QX | $39.50 | $39.50 | $39.50 |
AllWays Health Partners
| Facility | QY | $39.50 | $39.50 | $39.50 |
Mass General Brigham
| Facility | QK | $39.50 | $39.50 | $39.50 |
Mass General Brigham
| Facility | QX | $39.50 | $39.50 | $39.50 |
Mass General Brigham
| Facility | QY | $39.50 | $39.50 | $39.50 |
United
| Professional | AA | $88.00 | $88.00 | $88.00 |