Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.14 / $27.14 / $99.12	Facility	26	$27.14	$27.14	$99.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $85.29 / $130.90	Professional		$70.09	$85.29	$130.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.14 / $32.57 / $51.26	Professional	26	$27.14	$32.57	$51.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $261.05 / $261.05 / $261.05	Professional	50	$261.05	$261.05	$261.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.46 / $49.35 / $79.63	Professional	TC	$39.46	$49.35	$79.63
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $74.77 / $79.51 / $161.31	Facility	26	$74.77	$79.51	$161.31
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $74.14 / $140.44 / $603.17	Professional		$74.14	$140.44	$603.17
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $30.34 / $51.44 / $335.18	Professional	26	$30.34	$51.44	$335.18
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $44.66 / $92.23 / $360.07	Professional	TC	$44.66	$92.23	$360.07
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $86.96 / $86.96 / $139.63	Professional	50	$86.96	$86.96	$139.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.97 / $57.97 / $93.09	Professional	TC	$57.97	$57.97	$93.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.37 / $139.93 / $255.26	Professional		$81.37	$139.93	$255.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.28 / $54.79 / $96.23	Professional	26	$32.28	$54.79	$96.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.32 / $89.93 / $164.28	Professional	TC	$54.32	$89.93	$164.28
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $68.70 / $132.68	Professional		$40.88	$68.70	$132.68
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $82.58 / $172.82 / $238.86	Professional		$82.58	$172.82	$238.86
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.32 / $76.98 / $102.83	Professional	26	$39.32	$76.98	$102.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $52.02 / $103.12 / $136.04	Professional	TC	$52.02	$103.12	$136.04
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $74.77 / $161.31 / $161.31	Facility	26	$74.77	$161.31	$161.31
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $89.30 / $141.84 / $603.17	Professional		$89.30	$141.84	$603.17
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $50.52 / $335.18	Professional	26	$32.79	$50.52	$335.18
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $56.66 / $92.23 / $360.07	Professional	TC	$56.66	$92.23	$360.07
United Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $128.21 / $206.86	Professional		$86.25	$128.21	$206.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $47.68 / $86.81	Professional	26	$32.24	$47.68	$86.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.87 / $78.40 / $145.05	Professional	TC	$50.87	$78.40	$145.05