Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $53.70 / $223.87	Facility	26	$25.12	$53.70	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $239.88 / $501.19	Professional		$104.71	$239.88	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $67.61 / $134.90	Professional	26	$30.90	$67.61	$134.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $69.18 / $120.23 / $275.42	Professional	52	$69.18	$120.23	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $120.23 / $302.00	Professional	TC	$70.79	$120.23	$302.00
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $208.93 / $208.93	Facility	26	$77.62	$208.93	$208.93
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $776.25	Professional		$95.50	$162.18	$776.25
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $45.71 / $288.40	Professional	26	$28.18	$45.71	$288.40
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $123.03 / $575.44	Professional	TC	$70.79	$123.03	$575.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $245.47 / $354.81	Professional		$154.88	$245.47	$354.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $64.57 / $85.11	Professional	26	$37.15	$64.57	$85.11
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $18.62 / $69.18 / $173.78	Professional	52	$18.62	$69.18	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $173.78 / $338.84	Professional		$102.33	$173.78	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $47.86 / $93.33	Professional	26	$28.84	$47.86	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $123.03 / $251.19	Professional	TC	$69.18	$123.03	$251.19
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $128.82 / $245.47	Professional		$42.66	$128.82	$245.47
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $208.93 / $323.59	Professional		$120.23	$208.93	$323.59
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $56.23 / $87.10	Professional	26	$33.11	$56.23	$87.10
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $144.54 / $234.42	Professional	TC	$87.10	$144.54	$234.42
Health New England Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $102.33 / $251.19	Professional		$46.77	$102.33	$251.19
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $208.93 / $208.93	Facility	26	$77.62	$208.93	$208.93
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $776.25	Professional		$95.50	$158.49	$776.25
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $288.40	Professional	26	$28.18	$44.67	$288.40
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $123.03 / $575.44	Professional	TC	$70.79	$123.03	$575.44
Tufts Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $114.82 / $229.09	Professional		$52.48	$114.82	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $158.49 / $331.13	Professional		$97.72	$158.49	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $91.20	Professional	26	$30.90	$45.71	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $117.49 / $239.88	Professional	TC	$66.07	$117.49	$239.88