Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.50 / $32.50 / $32.50	Facility		$32.50	$32.50	$32.50
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $260.00 / $668.14 / $2,306.88	Professional	AA	$260.00	$668.14	$2,306.88
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $221.00 / $500.90 / $873.14	Professional	QK	$221.00	$500.90	$873.14
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $291.58 / $630.82 / $1,675.88	Professional	QX	$291.58	$630.82	$1,675.88
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $268.13 / $616.40 / $781.20	Professional	QY	$268.13	$616.40	$781.20
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $676.31 / $676.31 / $747.50	Professional	QZ	$676.31	$676.31	$747.50
AllWays Health Partners Facility/Professional Facility Modifier Low / Median / High Price $27.76 / $82.00 / $818.35	Facility		$27.76	$82.00	$818.35
AllWays Health Partners Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
AllWays Health Partners Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
AllWays Health Partners Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
Cigna Facility/Professional Professional Modifier QK Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QK	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
Fallon Health Facility/Professional Facility Modifier Low / Median / High Price $83.43 / $4,618.00 / $9,239.00	Facility		$83.43	$4,618.00	$9,239.00
Health New England Facility/Professional Facility Modifier Low / Median / High Price $210.00 / $323.82 / $490.00	Facility		$210.00	$323.82	$490.00
Mass General Brigham Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Mass General Brigham Facility/Professional Facility Modifier QK Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QK	$39.50	$39.50	$39.50
Mass General Brigham Facility/Professional Facility Modifier QX Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QX	$39.50	$39.50	$39.50
Mass General Brigham Facility/Professional Facility Modifier QY Low / Median / High Price $39.50 / $39.50 / $39.50	Facility	QY	$39.50	$39.50	$39.50
United Facility/Professional Professional Modifier AA Low / Median / High Price $365.00 / $365.00 / $365.00	Professional	AA	$365.00	$365.00	$365.00