Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.68 / $78.68 / $94.45	Facility	26	$78.68	$78.68	$94.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.50 / $940.23 / $1,099.28	Professional		$787.50	$940.23	$1,099.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.75 / $103.27 / $352.10	Professional	26	$72.75	$103.27	$352.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $708.82 / $832.71 / $996.01	Professional	TC	$708.82	$832.71	$996.01
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $106.04 / $229.45 / $468.97	Facility	26	$106.04	$229.45	$468.97
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $672.47 / $1,256.96 / $3,888.98	Professional		$672.47	$1,256.96	$3,888.98
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $71.59 / $120.56 / $435.12	Professional	26	$71.59	$120.56	$435.12
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $600.89 / $1,063.22 / $3,729.42	Professional	TC	$600.89	$1,063.22	$3,729.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.94 / $187.49 / $261.67	Professional	26	$108.94	$187.49	$261.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $905.09 / $905.09 / $1,195.80	Professional	TC	$905.09	$905.09	$1,195.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,017.06 / $1,314.63 / $2,753.74	Professional		$1,017.06	$1,314.63	$2,753.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.85 / $143.66 / $287.73	Professional	26	$104.85	$143.66	$287.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $912.20 / $1,169.74 / $2,466.00	Professional	TC	$912.20	$1,169.74	$2,466.00
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $122.79 / $979.45 / $1,516.94	Professional		$122.79	$979.45	$1,516.94
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $984.27 / $1,817.95 / $2,808.85	Professional		$984.27	$1,817.95	$2,808.85
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $117.15 / $208.73 / $291.77	Professional	26	$117.15	$208.73	$291.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $867.12 / $1,544.95 / $2,159.65	Professional	TC	$867.12	$1,544.95	$2,159.65
Health New England Facility/Professional Professional Modifier Low / Median / High Price $138.31 / $147.80 / $151.55	Professional		$138.31	$147.80	$151.55
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $229.45 / $229.45 / $468.97	Facility	26	$229.45	$229.45	$468.97
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $966.60 / $1,373.03 / $5,628.92	Professional		$966.60	$1,373.03	$5,628.92
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $95.05 / $139.05 / $611.21	Professional	26	$95.05	$139.05	$611.21
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $871.59 / $1,215.30 / $5,017.71	Professional	TC	$871.59	$1,215.30	$5,017.71
United Facility/Professional Professional Modifier Low / Median / High Price $966.60 / $1,307.27 / $2,634.82	Professional		$966.60	$1,307.27	$2,634.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.67 / $134.88 / $318.20	Professional	26	$95.67	$134.88	$318.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $867.12 / $1,215.30 / $3,056.58	Professional	TC	$867.12	$1,215.30	$3,056.58