Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.00 / $1,886.00 / $3,625.00	Facility		$537.00	$1,886.00	$3,625.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.94 / $129.94 / $129.94	Facility	26	$129.94	$129.94	$129.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.38 / $616.50 / $1,229.90	Professional		$368.38	$616.50	$1,229.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.31 / $179.65 / $423.15	Professional	26	$127.31	$179.65	$423.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.11 / $260.52 / $599.29	Professional	TC	$214.11	$260.52	$599.29
AllWays Health Partners Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $1,275.80 / $3,804.00	Facility		$540.00	$1,275.80	$3,804.00
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $272.52 / $302.48 / $403.72	Facility	26	$272.52	$302.48	$403.72
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $379.87 / $720.50 / $2,582.80	Professional		$379.87	$720.50	$2,582.80
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $121.16 / $248.11 / $908.96	Professional	26	$121.16	$248.11	$908.96
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $246.01 / $491.56 / $1,745.64	Professional	TC	$246.01	$491.56	$1,745.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $417.22 / $721.23 / $1,363.47	Professional		$417.22	$721.23	$1,363.47
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.32 / $232.20 / $438.96	Professional	26	$134.32	$232.20	$438.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $282.89 / $489.04 / $924.51	Professional	TC	$282.89	$489.04	$924.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $507.64 / $835.94 / $1,541.42	Professional		$507.64	$835.94	$1,541.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $165.24 / $250.61 / $454.20	Professional	26	$165.24	$250.61	$454.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $328.58 / $589.62 / $1,087.22	Professional	TC	$328.58	$589.62	$1,087.22
Fallon Health Facility/Professional Facility Modifier Low / Median / High Price $241.01 / $543.79 / $6,679.00	Facility		$241.01	$543.79	$6,679.00
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $238.59 / $545.48	Professional		$91.69	$238.59	$545.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $440.73 / $873.70 / $1,171.46	Professional		$440.73	$873.70	$1,171.46
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $152.78 / $302.87 / $384.55	Professional	26	$152.78	$302.87	$384.55
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $287.95 / $570.83 / $724.77	Professional	TC	$287.95	$570.83	$724.77
Health New England Facility/Professional Facility Modifier Low / Median / High Price $684.22 / $701.92 / $1,706.04	Facility		$684.22	$701.92	$1,706.04
Health New England Facility/Professional Professional Modifier Low / Median / High Price $164.79 / $198.80 / $713.33	Professional		$164.79	$198.80	$713.33
Mass General Brigham Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,891.36 / $7,161.00	Facility		$55.00	$1,891.36	$7,161.00
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $319.48 / $319.48 / $603.96	Facility	26	$319.48	$319.48	$603.96
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $442.71 / $739.67 / $2,582.80	Professional		$442.71	$739.67	$2,582.80
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $143.22 / $258.18 / $908.96	Professional	26	$143.22	$258.18	$908.96
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $301.14 / $543.79 / $1,745.64	Professional	TC	$301.14	$543.79	$1,745.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,408.00 / $5,683.00	Facility		$1,106.00	$2,408.00	$5,683.00
United Facility/Professional Professional Modifier Low / Median / High Price $401.11 / $582.16 / $1,342.43	Professional		$401.11	$582.16	$1,342.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $141.57 / $198.12 / $456.06	Professional	26	$141.57	$198.12	$456.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $246.01 / $391.35 / $874.72	Professional	TC	$246.01	$391.35	$874.72