| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
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 | QZ | $80.00 | $80.00 | $80.00 |