| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,758.00 | $2,733.00 | $4,712.00 | |
AllWays Health Partners
| Facility | $1,485.00 | $4,402.00 | $15,220.00 | |
AllWays Health Partners
| Facility | AS | $210.82 | $210.82 | $2,396.92 |
Fallon Health
| Facility | $826.48 | $1,790.94 | $6,679.00 | |
Mass General Brigham
| Facility | $2,155.00 | $5,268.00 | $26,542.00 | |
Mass General Brigham
| Facility | AS | $210.82 | $210.82 | $2,396.92 |
United
| Facility | $1,850.00 | $5,572.00 | $11,272.00 |