| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,924.00 | $2,747.00 | $5,454.00 | |
Aetna
| Facility | 50 | $5,411.18 | $5,411.18 | $5,411.18 |
AllWays Health Partners
| Facility | $1,485.00 | $4,402.00 | $9,401.00 | |
AllWays Health Partners
| Facility | AS | $188.63 | $188.63 | $849.00 |
Fallon Health
| Facility | $739.96 | $1,600.92 | $6,679.00 | |
Mass General Brigham
| Facility | $2,155.00 | $5,268.00 | $26,542.00 | |
Mass General Brigham
| Facility | AS | $188.63 | $188.63 | $849.00 |
United
| Facility | $2,155.00 | $4,983.00 | $8,810.00 |