Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $64.57 / $190.55	Facility	26	$37.15	$64.57	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $269.15 / $616.60	Professional		$120.23	$269.15	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $102.33 / $204.17	Professional	26	$42.66	$102.33	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $114.82 / $331.13	Professional	TC	$74.13	$114.82	$331.13
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $117.49 / $295.12	Facility	26	$52.48	$117.49	$295.12
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $870.96	Professional		$112.20	$186.21	$870.96
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $66.07 / $295.12	Professional	26	$40.74	$66.07	$295.12
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $128.82 / $575.44	Professional	TC	$77.62	$128.82	$575.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $398.11	Professional		$173.78	$281.84	$398.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $91.20 / $123.03	Professional	26	$53.70	$91.20	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $204.17 / $407.38	Professional		$117.49	$204.17	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $69.18 / $138.04	Professional	26	$41.69	$69.18	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $141.25 / $269.15	Professional	TC	$77.62	$141.25	$269.15
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $138.04 / $275.42	Professional		$61.66	$138.04	$275.42
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $239.88 / $363.08	Professional		$138.04	$239.88	$363.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $77.62 / $125.89	Professional	26	$47.86	$77.62	$125.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $158.49 / $245.47	Professional	TC	$91.20	$158.49	$245.47
Health New England Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $213.80 / $457.09	Professional		$93.33	$213.80	$457.09
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $117.49 / $295.12	Facility	26	$52.48	$117.49	$295.12
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $870.96	Professional		$112.20	$186.21	$870.96
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $63.10 / $295.12	Professional	26	$40.74	$63.10	$295.12
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $125.89 / $575.44	Professional	TC	$77.62	$125.89	$575.44
Tufts Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $281.84	Professional		$117.49	$151.36	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $380.19	Professional		$125.89	$190.55	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $66.07 / $131.83	Professional	26	$44.67	$66.07	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $125.89 / $251.19	Professional	TC	$83.18	$125.89	$251.19