Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.89 / $118.89 / $119.73	Facility		$118.89	$118.89	$119.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $118.89 / $118.89 / $118.89	Facility	TC	$118.89	$118.89	$118.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.36 / $91.14 / $118.88	Professional		$50.36	$91.14	$118.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.10 / $47.79 / $194.33	Professional	26	$21.10	$47.79	$194.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.26 / $42.18 / $79.73	Professional	TC	$29.26	$42.18	$79.73
AllWays Health Partners Facility/Professional Facility Modifier Low / Median / High Price $379.47 / $379.47 / $379.47	Facility		$379.47	$379.47	$379.47
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $234.18 / $234.18 / $234.18	Facility	26	$234.18	$234.18	$234.18
AllWays Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $224.87 / $224.87 / $224.87	Facility	TC	$224.87	$224.87	$224.87
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $67.91 / $137.74 / $645.55	Professional		$67.91	$137.74	$645.55
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $59.13 / $513.00	Professional	26	$28.87	$59.13	$513.00
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $36.99 / $73.18 / $321.52	Professional	TC	$36.99	$73.18	$321.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.88 / $72.88 / $72.88	Facility		$72.88	$72.88	$72.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $132.09 / $180.41	Professional		$73.04	$132.09	$180.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.67 / $50.65 / $68.40	Professional	26	$36.67	$50.65	$68.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.13 / $85.48 / $115.81	Professional	TC	$52.13	$85.48	$115.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $62.61 / $163.53	Professional		$36.50	$62.61	$163.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $26.48 / $81.95	Professional	26	$14.43	$26.48	$81.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.15 / $35.63 / $80.84	Professional	TC	$21.15	$35.63	$80.84
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $33.40 / $61.79 / $120.88	Professional		$33.40	$61.79	$120.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $153.00 / $211.03	Professional		$67.40	$153.00	$211.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $32.77 / $61.94 / $85.70	Professional	26	$32.77	$61.94	$85.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $50.38 / $95.57 / $128.41	Professional	TC	$50.38	$95.57	$128.41
Health New England Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $96.66 / $252.15	Professional		$41.92	$96.66	$252.15
Health New England Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $27.35 / $27.35	Professional	26	$27.35	$27.35	$27.35
Mass General Brigham Facility/Professional Facility Modifier Low / Median / High Price $379.47 / $379.47 / $379.47	Facility		$379.47	$379.47	$379.47
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $234.18 / $234.18 / $234.18	Facility	26	$234.18	$234.18	$234.18
Mass General Brigham Facility/Professional Facility Modifier TC Low / Median / High Price $224.87 / $224.87 / $224.87	Facility	TC	$224.87	$224.87	$224.87
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $135.91 / $645.55	Professional		$68.56	$135.91	$645.55
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $55.86 / $513.00	Professional	26	$28.07	$55.86	$513.00
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $35.50 / $70.73 / $321.52	Professional	TC	$35.50	$70.73	$321.52
Tufts Facility/Professional Facility Modifier Low / Median / High Price $51.88 / $79.38 / $153.78	Facility		$51.88	$79.38	$153.78
Tufts Facility/Professional Professional Modifier Low / Median / High Price $57.07 / $100.34 / $136.21	Professional		$57.07	$100.34	$136.21
United Facility/Professional Professional Modifier Low / Median / High Price $48.09 / $78.45 / $197.11	Professional		$48.09	$78.45	$197.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.77 / $36.04 / $75.11	Professional	26	$18.77	$36.04	$75.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.31 / $47.19 / $100.77	Professional	TC	$28.31	$47.19	$100.77