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 $532.00 / $688.69 / $832.60	Professional	AA	$532.00	$688.69	$832.60
Aetna Facility/Professional Professional Modifier QK Low / Median / High Price $243.20 / $604.48 / $853.96	Professional	QK	$243.20	$604.48	$853.96
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $253.25 / $614.08 / $882.74	Professional	QX	$253.25	$614.08	$882.74
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $234.83 / $565.88 / $818.50	Professional	QY	$234.83	$565.88	$818.50
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $618.46 / $710.09 / $790.26	Professional	QZ	$618.46	$710.09	$790.26
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 $175.00 / $231.30 / $280.00	Facility		$175.00	$231.30	$280.00
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