| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $826.50 | $826.50 | $826.50 | |
Aetna
| Professional | $826.50 | $826.50 | $826.50 | |
AllWays Health Partners
| Facility | $100.00 | $100.00 | $100.00 | |
AllWays Health Partners
| Professional | $75.16 | $75.16 | $75.16 | |
Mass General Brigham
| Facility | $100.00 | $100.00 | $100.00 | |
Mass General Brigham
| Professional | $75.16 | $75.16 | $75.16 |