Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,537.92 / $1,915.28 / $2,523.15	Professional	AA	$1,537.92	$1,915.28	$2,523.15
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $65.02 / $1,401.76 / $1,915.28	Professional	QX	$65.02	$1,401.76	$1,915.28
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $1,197.06 / $1,197.06 / $1,675.88	Professional	QY	$1,197.06	$1,197.06	$1,675.88
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 QX Low / Median / High Price $120.00 / $120.00 / $120.00	Professional	QX	$120.00	$120.00	$120.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $120.00 / $120.00 / $120.00	Professional	QY	$120.00	$120.00	$120.00
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