Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $398.11 / $1,122.02	Professional		$275.42	$398.11	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $114.82 / $354.81	Professional	26	$93.33	$114.82	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $263.03 / $676.08	Professional	TC	$177.83	$263.03	$676.08
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $257.04 / $645.65	Facility	26	$229.09	$257.04	$645.65
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $512.86 / $1,318.26	Professional		$288.40	$512.86	$1,318.26
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $158.49 / $407.38	Professional	26	$79.43	$158.49	$407.38
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $371.54 / $933.25	Professional	TC	$208.93	$371.54	$933.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,096.48 / $1,348.96	Professional		$588.84	$1,096.48	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $676.08 / $1,479.11	Professional		$380.19	$676.08	$1,479.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $208.93 / $363.08	Professional	26	$120.23	$208.93	$363.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $457.09 / $870.96	Professional	TC	$257.04	$457.09	$870.96
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $213.80 / $501.19	Professional		$77.62	$213.80	$501.19
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $602.56 / $1,023.29	Professional		$338.84	$602.56	$1,023.29
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $194.98 / $281.84	Professional	26	$109.65	$194.98	$281.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $416.87 / $616.60	Professional	TC	$229.09	$416.87	$616.60
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $257.04 / $645.65	Facility	26	$229.09	$257.04	$645.65
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $512.86 / $1,318.26	Professional		$288.40	$512.86	$1,318.26
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $154.88 / $407.38	Professional	26	$79.43	$154.88	$407.38
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $371.54 / $933.25	Professional	TC	$208.93	$371.54	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $1,258.93	Professional		$363.08	$549.54	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $177.83 / $316.23	Professional	26	$120.23	$177.83	$316.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $380.19 / $776.25	Professional	TC	$245.47	$380.19	$776.25