Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.72 / $119.27 / $248.06	Facility	26	$83.72	$119.27	$248.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.74 / $475.00 / $1,390.00	Professional		$345.74	$475.00	$1,390.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.79 / $127.50 / $285.22	Professional	26	$88.79	$127.50	$285.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $256.94 / $335.00 / $484.30	Professional	TC	$256.94	$335.00	$484.30
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $199.24 / $620.48 / $779.12	Facility	26	$199.24	$620.48	$779.12
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $398.19 / $639.57 / $3,045.40	Professional		$398.19	$639.57	$3,045.40
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $81.97 / $128.84 / $850.86	Professional	26	$81.97	$128.84	$850.86
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $311.98 / $552.33 / $2,616.37	Professional	TC	$311.98	$552.33	$2,616.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.40 / $161.79 / $215.02	Professional	26	$108.40	$161.79	$215.02
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,058.49 / $1,242.90 / $1,242.90	Professional	50	$1,058.49	$1,242.90	$1,242.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $705.66 / $828.60 / $828.60	Professional	TC	$705.66	$828.60	$828.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $351.08 / $663.16 / $1,248.83	Professional		$351.08	$663.16	$1,248.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.44 / $127.74 / $258.47	Professional	26	$84.44	$127.74	$258.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $322.83 / $573.17 / $1,040.33	Professional	TC	$322.83	$573.17	$1,040.33
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $108.84 / $384.53 / $680.01	Professional		$108.84	$384.53	$680.01
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $419.84 / $845.56 / $1,097.92	Professional		$419.84	$845.56	$1,097.92
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $104.04 / $207.50 / $272.08	Professional	26	$104.04	$207.50	$272.08
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $315.80 / $631.60 / $825.85	Professional	TC	$315.80	$631.60	$825.85
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $620.48 / $779.12 / $779.12	Facility	26	$620.48	$779.12	$779.12
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $398.19 / $650.46 / $3,045.40	Professional		$398.19	$650.46	$3,045.40
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $85.45 / $136.62 / $850.86	Professional	26	$85.45	$136.62	$850.86
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $311.27 / $562.23 / $2,616.37	Professional	TC	$311.27	$562.23	$2,616.37
United Facility/Professional Professional Modifier Low / Median / High Price $392.65 / $559.90 / $1,056.74	Professional		$392.65	$559.90	$1,056.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.29 / $107.40 / $220.76	Professional	26	$83.29	$107.40	$220.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $300.62 / $429.33 / $767.31	Professional	TC	$300.62	$429.33	$767.31