| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $263.03 | $426.58 | $426.58 |
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 |