Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.70 / $97.79 / $203.92	Facility	26	$96.70	$97.79	$203.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.94 / $75.45 / $131.15	Facility	53	$52.94	$75.45	$131.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $1,427.87	Professional		$250.00	$475.00	$1,427.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.63 / $112.50 / $254.90	Professional	26	$67.63	$112.50	$254.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.66 / $185.25 / $300.00	Professional	52	$101.66	$185.25	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.11 / $297.50 / $472.35	Professional	TC	$130.11	$297.50	$472.35
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $164.95 / $507.76 / $638.88	Facility	26	$164.95	$507.76	$638.88
AllWays Health Partners Facility/Professional Facility Modifier 53 Low / Median / High Price $85.26 / $285.58 / $285.58	Facility	53	$85.26	$285.58	$285.58
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $232.42 / $476.60 / $2,958.99	Professional		$232.42	$476.60	$2,958.99
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $62.63 / $108.39 / $584.49	Professional	26	$62.63	$108.39	$584.49
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $157.97 / $329.39 / $2,573.94	Professional	TC	$157.97	$329.39	$2,573.94
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.61 / $133.52 / $202.99	Professional	26	$94.61	$133.52	$202.99
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $55.69 / $273.56 / $524.79	Professional	52	$55.69	$273.56	$524.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $512.82 / $548.38 / $682.46	Professional	TC	$512.82	$548.38	$682.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.42 / $500.16 / $1,066.16	Professional		$232.42	$500.16	$1,066.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.67 / $108.03 / $213.99	Professional	26	$69.67	$108.03	$213.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.84 / $339.98 / $735.57	Professional	TC	$162.84	$339.98	$735.57
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $89.28 / $200.85 / $374.35	Professional		$89.28	$200.85	$374.35
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $244.94 / $488.51 / $640.54	Professional		$244.94	$488.51	$640.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $170.40 / $222.81	Professional	26	$85.20	$170.40	$222.81
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $159.74 / $318.58 / $417.74	Professional	TC	$159.74	$318.58	$417.74
Health New England Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $140.22 / $477.39	Professional		$108.99	$140.22	$477.39
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $507.76 / $638.88 / $638.88	Facility	26	$507.76	$638.88	$638.88
Mass General Brigham Facility/Professional Facility Modifier 53 Low / Median / High Price $85.26 / $285.58 / $285.58	Facility	53	$85.26	$285.58	$285.58
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $236.20 / $503.51 / $2,958.99	Professional		$236.20	$503.51	$2,958.99
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $70.59 / $113.05 / $584.49	Professional	26	$70.59	$113.05	$584.49
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $155.79 / $401.86 / $2,573.94	Professional	TC	$155.79	$401.86	$2,573.94
Tufts Facility/Professional Professional Modifier Low / Median / High Price $147.44 / $286.66 / $511.56	Professional		$147.44	$286.66	$511.56
United Facility/Professional Professional Modifier Low / Median / High Price $219.32 / $418.48 / $806.33	Professional		$219.32	$418.48	$806.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.28 / $94.29 / $188.04	Professional	26	$67.28	$94.29	$188.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.49 / $240.78 / $566.49	Professional	TC	$150.49	$240.78	$566.49