Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.00 / $12.00 / $44.55	Facility	26	$12.00	$12.00	$44.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.80 / $59.21 / $195.30	Professional		$44.80	$59.21	$195.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $16.13 / $42.25	Professional	26	$12.00	$16.13	$42.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $42.80 / $113.49	Professional	TC	$32.79	$42.80	$113.49
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $35.32 / $37.11 / $73.77	Facility	26	$35.32	$37.11	$73.77
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $85.93 / $395.03	Professional		$56.27	$85.93	$395.03
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $21.18 / $93.99	Professional	26	$14.81	$21.18	$93.99
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $42.31 / $65.51 / $301.02	Professional	TC	$42.31	$65.51	$301.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $28.73 / $38.19	Professional	26	$17.19	$28.73	$38.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.94 / $98.32 / $132.78	Professional	TC	$66.94	$98.32	$132.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.69 / $96.64 / $196.85	Professional		$62.69	$96.64	$196.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $25.28 / $44.57	Professional	26	$16.05	$25.28	$44.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.47 / $74.05 / $153.02	Professional	TC	$46.47	$74.05	$153.02
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $19.28 / $69.77 / $120.86	Professional		$19.28	$69.77	$120.86
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $76.19 / $151.94 / $202.51	Professional		$76.19	$151.94	$202.51
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $18.43 / $36.54 / $48.20	Professional	26	$18.43	$36.54	$48.20
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $57.75 / $115.18 / $151.02	Professional	TC	$57.75	$115.18	$151.02
Health New England Facility/Professional Professional Modifier Low / Median / High Price $21.92 / $46.44 / $142.66	Professional		$21.92	$46.44	$142.66
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $35.32 / $73.77 / $73.77	Facility	26	$35.32	$73.77	$73.77
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $59.68 / $86.88 / $395.03	Professional		$59.68	$86.88	$395.03
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $21.94 / $93.99	Professional	26	$15.77	$21.94	$93.99
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $63.29 / $301.02	Professional	TC	$43.67	$63.29	$301.02
United Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $83.40 / $144.41	Professional		$59.40	$83.40	$144.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $20.27 / $37.33	Professional	26	$15.26	$20.27	$37.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $62.30 / $112.16	Professional	TC	$43.67	$62.30	$112.16