| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $591.50 | $1,540.00 | $3,591.15 |
Aetna
| Professional | QZ | $615.60 | $615.60 | $615.60 |
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 |