Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.83 / $44.54 / $107.44	Facility		$37.83	$44.54	$107.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.67 / $15.02 / $32.13	Facility	26	$8.67	$15.02	$32.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.60 / $77.93 / $277.14	Facility	TC	$22.60	$77.93	$277.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.28 / $40.63 / $102.95	Professional		$31.28	$40.63	$102.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $11.37 / $27.60	Professional	26	$8.68	$11.37	$27.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $185.12 / $185.12 / $185.12	Professional	50	$185.12	$185.12	$185.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.60 / $27.94 / $65.00	Professional	TC	$22.60	$27.94	$65.00
AllWays Health Partners Facility/Professional Facility Modifier Low / Median / High Price $38.39 / $119.26 / $359.91	Facility		$38.39	$119.26	$359.91
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $26.50 / $70.00	Facility	26	$25.22	$26.50	$70.00
AllWays Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $65.04 / $81.40 / $168.01	Facility	TC	$65.04	$81.40	$168.01
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $57.78 / $265.10	Professional		$39.24	$57.78	$265.10
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $15.11 / $68.20	Professional	26	$10.70	$15.11	$68.20
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $43.51 / $196.89	Professional	TC	$28.83	$43.51	$196.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $160.83 / $321.64	Facility		$106.00	$160.83	$321.64
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $20.51 / $27.26	Professional	26	$15.62	$20.51	$27.26
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $25.62 / $42.83 / $56.91	Professional	52	$25.62	$42.83	$56.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.96 / $56.06 / $110.14	Professional	TC	$38.96	$56.06	$110.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $119.03 / $207.82 / $388.58	Facility		$119.03	$207.82	$388.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.96 / $65.19 / $131.93	Professional		$41.96	$65.19	$131.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $18.16 / $31.87	Professional	26	$11.50	$18.16	$31.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.58 / $49.13 / $100.06	Professional	TC	$30.58	$49.13	$100.06
Fallon Health Facility/Professional Facility Modifier Low / Median / High Price $37.47 / $83.43 / $6,679.00	Facility		$37.47	$83.43	$6,679.00
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $13.75 / $45.66 / $80.45	Professional		$13.75	$45.66	$80.45
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $43.17 / $101.30 / $135.00	Professional		$43.17	$101.30	$135.00
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $13.11 / $24.87 / $34.28	Professional	26	$13.11	$24.87	$34.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $37.68 / $74.70 / $98.54	Professional	TC	$37.68	$74.70	$98.54
Health New England Facility/Professional Facility Modifier Low / Median / High Price $22.17 / $151.05 / $456.74	Facility		$22.17	$151.05	$456.74
Health New England Facility/Professional Professional Modifier Low / Median / High Price $15.58 / $33.86 / $87.85	Professional		$15.58	$33.86	$87.85
Mass General Brigham Facility/Professional Facility Modifier Low / Median / High Price $88.07 / $359.91 / $359.91	Facility		$88.07	$359.91	$359.91
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $25.22 / $70.00 / $70.00	Facility	26	$25.22	$70.00	$70.00
Mass General Brigham Facility/Professional Facility Modifier TC Low / Median / High Price $65.04 / $168.01 / $168.01	Facility	TC	$65.04	$168.01	$168.01
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $40.42 / $60.06 / $265.10	Professional		$40.42	$60.06	$265.10
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $15.60 / $68.20	Professional	26	$11.21	$15.60	$68.20
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $43.30 / $196.89	Professional	TC	$28.92	$43.30	$196.89
United Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $54.43 / $96.14	Professional		$40.04	$54.43	$96.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $14.98 / $26.96	Professional	26	$11.01	$14.98	$26.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $39.45 / $73.12	Professional	TC	$28.87	$39.45	$73.12