Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.76 / $27.77 / $101.16	Facility	26	$27.76	$27.77	$101.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $140.90 / $419.30	Professional		$110.05	$140.90	$419.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.77 / $37.68 / $98.15	Professional	26	$27.77	$37.68	$98.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.95 / $119.66 / $207.90	Professional	52	$33.95	$119.66	$207.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $99.73 / $254.80	Professional	TC	$82.29	$99.73	$254.80
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $85.37 / $141.76 / $177.27	Facility	26	$85.37	$141.76	$177.27
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $147.47 / $201.74 / $825.92	Professional		$147.47	$201.74	$825.92
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $38.31 / $52.65 / $227.63	Professional	26	$38.31	$52.65	$227.63
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $106.16 / $148.71 / $598.35	Professional	TC	$106.16	$148.71	$598.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.43 / $249.80 / $490.74	Professional		$146.43	$249.80	$490.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.26 / $68.97 / $91.66	Professional	26	$41.26	$68.97	$91.66
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $29.69 / $121.69 / $180.26	Professional	52	$29.69	$121.69	$180.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.75 / $230.90 / $410.15	Professional		$146.75	$230.90	$410.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.44 / $59.00 / $106.97	Professional	26	$38.44	$59.00	$106.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.81 / $175.61 / $304.16	Professional	TC	$114.81	$175.61	$304.16
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $46.33 / $137.72 / $241.65	Professional		$46.33	$137.72	$241.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $157.69 / $299.16 / $412.40	Professional		$157.69	$299.16	$412.40
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.24 / $87.70 / $115.69	Professional	26	$44.24	$87.70	$115.69
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $113.46 / $226.28 / $296.70	Professional	TC	$113.46	$226.28	$296.70
Health New England Facility/Professional Professional Modifier Low / Median / High Price $50.70 / $107.00 / $298.43	Professional		$50.70	$107.00	$298.43
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $85.37 / $177.27 / $177.27	Facility	26	$85.37	$177.27	$177.27
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $145.63 / $199.20 / $825.92	Professional		$145.63	$199.20	$825.92
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $52.26 / $227.63	Professional	26	$39.34	$52.26	$227.63
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $106.32 / $148.09 / $598.35	Professional	TC	$106.32	$148.09	$598.35
Tufts Facility/Professional Professional Modifier Low / Median / High Price $116.40 / $154.00 / $258.04	Professional		$116.40	$154.00	$258.04
United Facility/Professional Professional Modifier Low / Median / High Price $139.31 / $193.54 / $343.52	Professional		$139.31	$193.54	$343.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.60 / $50.78 / $109.37	Professional	26	$37.60	$50.78	$109.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.81 / $142.76 / $245.88	Professional	TC	$102.81	$142.76	$245.88