Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.45 / $50.53 / $150.78	Facility	26	$40.45	$50.53	$150.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.54 / $218.98 / $378.12	Professional		$114.54	$218.98	$378.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.43 / $55.21 / $160.11	Professional	26	$44.43	$55.21	$160.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.09 / $145.74 / $240.00	Professional	TC	$74.09	$145.74	$240.00
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $120.89 / $373.44 / $470.00	Facility	26	$120.89	$373.44	$470.00
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $142.24 / $301.52 / $1,640.91	Professional		$142.24	$301.52	$1,640.91
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $49.17 / $77.81 / $325.83	Professional	26	$49.17	$77.81	$325.83
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $90.33 / $208.16 / $1,357.90	Professional	TC	$90.33	$208.16	$1,357.90
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.45 / $97.71 / $149.35	Professional	26	$58.45	$97.71	$149.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $215.52 / $215.52 / $440.92	Professional	TC	$215.52	$215.52	$440.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.63 / $297.30 / $484.03	Professional		$156.63	$297.30	$484.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.26 / $76.84 / $157.18	Professional	26	$51.26	$76.84	$157.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.90 / $196.85 / $398.42	Professional	TC	$101.90	$196.85	$398.42
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $65.69 / $131.58 / $253.32	Professional		$65.69	$131.58	$253.32
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $165.89 / $314.69 / $433.82	Professional		$165.89	$314.69	$433.82
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.67 / $124.99 / $163.89	Professional	26	$62.67	$124.99	$163.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $103.22 / $207.89 / $269.93	Professional	TC	$103.22	$207.89	$269.93
Health New England Facility/Professional Professional Modifier Low / Median / High Price $74.51 / $90.17 / $146.76	Professional		$74.51	$90.17	$146.76
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $373.44 / $470.00 / $470.00	Facility	26	$373.44	$470.00	$470.00
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $155.19 / $311.47 / $1,640.91	Professional		$155.19	$311.47	$1,640.91
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $51.91 / $82.88 / $325.83	Professional	26	$51.91	$82.88	$325.83
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $95.28 / $226.35 / $1,357.90	Professional	TC	$95.28	$226.35	$1,357.90
Tufts Facility/Professional Professional Modifier Low / Median / High Price $118.40 / $193.60 / $228.66	Professional		$118.40	$193.60	$228.66
United Facility/Professional Professional Modifier Low / Median / High Price $147.61 / $247.40 / $438.79	Professional		$147.61	$247.40	$438.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.98 / $70.23 / $127.65	Professional	26	$49.98	$70.23	$127.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.03 / $142.03 / $310.60	Professional	TC	$92.03	$142.03	$310.60