Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.58 / $151.58 / $315.89	Facility	26	$151.58	$151.58	$315.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $531.57 / $2,326.64	Professional		$370.50	$531.57	$2,326.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.43 / $151.58 / $369.78	Professional	26	$110.43	$151.58	$369.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $164.80 / $212.50 / $300.00	Professional	52	$164.80	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.62 / $350.31 / $1,651.94	Professional	TC	$216.62	$350.31	$1,651.94
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $254.53 / $791.52 / $993.60	Facility	26	$254.53	$791.52	$993.60
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $377.95 / $815.41 / $6,330.97	Professional		$377.95	$815.41	$6,330.97
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $99.55 / $164.54 / $921.60	Professional	26	$99.55	$164.54	$921.60
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $263.07 / $559.51 / $5,717.71	Professional	TC	$263.07	$559.51	$5,717.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.36 / $20.66 / $31.58	Professional		$12.36	$20.66	$31.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $138.44 / $206.63 / $315.85	Professional	26	$138.44	$206.63	$315.85
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $83.88 / $435.04 / $826.97	Professional	52	$83.88	$435.04	$826.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $853.97 / $865.71 / $1,143.43	Professional	TC	$853.97	$865.71	$1,143.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $377.95 / $759.68 / $1,598.16	Professional		$377.95	$759.68	$1,598.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.35 / $167.19 / $335.70	Professional	26	$108.35	$167.19	$335.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $272.82 / $566.13 / $1,240.22	Professional	TC	$272.82	$566.13	$1,240.22
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $138.87 / $327.79 / $607.92	Professional		$138.87	$327.79	$607.92
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $397.72 / $801.01 / $1,040.08	Professional		$397.72	$801.01	$1,040.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $132.71 / $264.68 / $347.05	Professional	26	$132.71	$264.68	$347.05
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $265.01 / $528.54 / $693.03	Professional	TC	$265.01	$528.54	$693.03
Health New England Facility/Professional Professional Modifier Low / Median / High Price $156.33 / $215.65 / $759.46	Professional		$156.33	$215.65	$759.46
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $791.52 / $993.60 / $993.60	Facility	26	$791.52	$993.60	$993.60
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $386.46 / $982.80 / $6,330.97	Professional		$386.46	$982.80	$6,330.97
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $108.96 / $175.05 / $921.60	Professional	26	$108.96	$175.05	$921.60
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $262.36 / $641.01 / $5,717.71	Professional	TC	$262.36	$641.01	$5,717.71
Tufts Facility/Professional Professional Modifier Low / Median / High Price $251.95 / $479.01 / $713.57	Professional		$251.95	$479.01	$713.57
United Facility/Professional Professional Modifier Low / Median / High Price $370.64 / $620.03 / $1,420.12	Professional		$370.64	$620.03	$1,420.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.34 / $146.22 / $309.39	Professional	26	$106.34	$146.22	$309.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.35 / $405.36 / $1,251.53	Professional	TC	$253.35	$405.36	$1,251.53