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 $512.38 / $647.58 / $840.00	Professional	AA	$512.38	$647.58	$840.00
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $280.87 / $565.34 / $780.00	Professional	QK	$280.87	$565.34	$780.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $243.20 / $382.17 / $863.56	Professional	QX	$243.20	$382.17	$863.56
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $253.50 / $623.67 / $863.56	Professional	QY	$253.50	$623.67	$863.56
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $581.39 / $674.36 / $698.63	Professional	QZ	$581.39	$674.36	$698.63
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 $150.00 / $150.00 / $150.00	Professional	QK	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QX	$150.00	$150.00	$150.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	QY	$150.00	$150.00	$150.00
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 $350.00 / $420.00 / $490.00	Facility		$350.00	$420.00	$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