Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $3,019.95 / $4,570.88	Facility		$446.68	$3,019.95	$4,570.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $407.38 / $1,819.70	Professional		$338.84	$407.38	$1,819.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $158.49 / $630.96	Professional	26	$117.49	$158.49	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $269.15 / $588.84	Professional	TC	$213.80	$269.15	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $794.33	Professional		$389.05	$446.68	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $173.78 / $263.03	Professional	26	$147.91	$173.78	$263.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $295.12 / $512.86	Professional	TC	$223.87	$295.12	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $436.52	Professional		$32.36	$33.11	$436.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,122.02 / $2,630.27	Facility		$954.99	$1,122.02	$2,630.27
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility	26	$1,047.13	$1,047.13	$1,047.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $630.96 / $741.31	Professional		$501.19	$630.96	$741.31
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $239.88 / $288.40	Professional	26	$162.18	$239.88	$288.40
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $398.11 / $467.74	Professional	TC	$338.84	$398.11	$467.74
Select Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $645.65 / $741.31	Professional		$338.84	$645.65	$741.31
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $229.09 / $269.15	Professional	26	$123.03	$229.09	$269.15
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $407.38 / $478.63	Professional	TC	$213.80	$407.38	$478.63
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $363.08 / $616.60	Professional		$177.83	$363.08	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $2,818.38 / $5,128.61	Facility		$1,096.48	$2,818.38	$5,128.61
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $407.38 / $776.25	Professional		$331.13	$407.38	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $151.36 / $229.09	Professional	26	$120.23	$151.36	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $257.04 / $436.52	Professional	TC	$204.17	$257.04	$436.52