Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $104.71 / $281.84	Facility	26	$69.18	$104.71	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $478.63 / $1,412.54	Professional		$208.93	$478.63	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $138.04 / $331.13	Professional	26	$67.61	$138.04	$331.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $512.86 / $870.96	Professional	52	$158.49	$512.86	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $302.00 / $812.83	Professional	TC	$134.90	$302.00	$812.83
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $645.65 / $645.65	Facility	26	$165.96	$645.65	$645.65
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $416.87 / $3,019.95	Professional		$218.78	$416.87	$3,019.95
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $97.72 / $562.34	Professional	26	$63.10	$97.72	$562.34
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $302.00 / $2,570.40	Professional	TC	$147.91	$302.00	$2,570.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $645.65 / $1,096.48	Professional		$380.19	$645.65	$1,096.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $138.04 / $181.97	Professional	26	$79.43	$138.04	$181.97
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $39.81 / $190.55 / $436.52	Professional	52	$39.81	$190.55	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $457.09 / $851.14	Professional		$169.82	$457.09	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $208.93	Professional	26	$61.66	$107.15	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $323.59 / $645.65	Professional	TC	$128.82	$323.59	$645.65
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $204.17 / $446.68	Professional		$93.33	$204.17	$446.68
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $323.59 / $602.56	Professional		$204.17	$323.59	$602.56
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $186.21	Professional	26	$72.44	$104.71	$186.21
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $208.93 / $380.19	Professional	TC	$141.25	$208.93	$380.19
Health New England Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $602.56	Professional		$100.00	$128.82	$602.56
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $645.65 / $645.65	Facility	26	$165.96	$645.65	$645.65
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $416.87 / $3,019.95	Professional		$218.78	$416.87	$3,019.95
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $97.72 / $562.34	Professional	26	$64.57	$97.72	$562.34
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $302.00 / $2,570.40	Professional	TC	$147.91	$302.00	$2,570.40
Tufts Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $389.05	Professional		$151.36	$295.12	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $407.38 / $758.58	Professional		$218.78	$407.38	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $97.72 / $213.80	Professional	26	$70.79	$97.72	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $245.47 / $549.54	Professional	TC	$144.54	$245.47	$549.54