Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $184.42 / $184.42 / $184.42	Facility	26	$184.42	$184.42	$184.42
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $185.42 / $185.42 / $185.42	Facility	53	$185.42	$185.42	$185.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $690.82 / $1,010.53 / $3,222.45	Professional		$690.82	$1,010.53	$3,222.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.19 / $200.31 / $576.66	Professional	26	$112.19	$200.31	$576.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $335.54 / $463.56 / $605.58	Professional	52	$335.54	$463.56	$605.58
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $134.22 / $185.42 / $424.66	Professional	53	$134.22	$185.42	$424.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $564.08 / $767.25 / $1,108.33	Professional	TC	$564.08	$767.25	$1,108.33
AllWays Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $246.26 / $273.32 / $789.30	Facility	26	$246.26	$273.32	$789.30
AllWays Health Partners Facility/Professional Facility Modifier 53 Low / Median / High Price $281.39 / $754.92 / $754.92	Facility	53	$281.39	$754.92	$754.92
AllWays Health Partners Facility/Professional Professional Modifier Low / Median / High Price $860.24 / $1,595.35 / $5,492.22	Professional		$860.24	$1,595.35	$5,492.22
AllWays Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $119.23 / $249.33 / $1,044.83	Professional	26	$119.23	$249.33	$1,044.83
AllWays Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $741.02 / $1,455.77 / $4,549.22	Professional	TC	$741.02	$1,455.77	$4,549.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,265.91 / $1,702.82 / $2,964.59	Professional		$1,265.91	$1,702.82	$2,964.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $162.03 / $208.55 / $305.49	Professional	26	$162.03	$208.55	$305.49
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $648.50 / $874.66 / $2,825.20	Professional	52	$648.50	$874.66	$2,825.20
BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $324.26 / $437.34 / $1,412.63	Professional	53	$324.26	$437.34	$1,412.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,020.49 / $1,020.49 / $1,207.32	Professional	TC	$1,020.49	$1,020.49	$1,207.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $807.46 / $1,538.26 / $2,521.52	Professional		$807.46	$1,538.26	$2,521.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.54 / $234.15 / $401.50	Professional	26	$127.54	$234.15	$401.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $685.78 / $1,310.87 / $2,151.31	Professional	TC	$685.78	$1,310.87	$2,151.31
Fallon Health Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $482.88 / $1,141.04	Professional		$86.14	$482.88	$1,141.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $855.65 / $1,723.28 / $2,237.61	Professional		$855.65	$1,723.28	$2,237.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $135.16 / $269.58 / $344.55	Professional	26	$135.16	$269.58	$344.55
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $720.49 / $1,436.95 / $1,836.53	Professional	TC	$720.49	$1,436.95	$1,836.53
Health New England Facility/Professional Professional Modifier Low / Median / High Price $169.05 / $350.26 / $1,612.72	Professional		$169.05	$350.26	$1,612.72
Mass General Brigham Facility/Professional Facility Modifier 26 Low / Median / High Price $259.19 / $789.30 / $789.30	Facility	26	$259.19	$789.30	$789.30
Mass General Brigham Facility/Professional Facility Modifier 53 Low / Median / High Price $281.39 / $754.92 / $754.92	Facility	53	$281.39	$754.92	$754.92
Mass General Brigham Facility/Professional Professional Modifier Low / Median / High Price $887.05 / $1,722.94 / $5,492.22	Professional		$887.05	$1,722.94	$5,492.22
Mass General Brigham Facility/Professional Professional Modifier 26 Low / Median / High Price $143.06 / $280.73 / $1,044.83	Professional	26	$143.06	$280.73	$1,044.83
Mass General Brigham Facility/Professional Professional Modifier TC Low / Median / High Price $747.41 / $1,602.16 / $4,549.22	Professional	TC	$747.41	$1,602.16	$4,549.22
United Facility/Professional Professional Modifier Low / Median / High Price $879.50 / $1,443.87 / $3,120.32	Professional		$879.50	$1,443.87	$3,120.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $222.24 / $441.58	Professional	26	$132.09	$222.24	$441.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $747.41 / $1,192.82 / $2,217.39	Professional	TC	$747.41	$1,192.82	$2,217.39