Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $275.42 / $2,238.72	Facility		$177.83	$275.42	$2,238.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $100.00 / $302.00	Professional		$34.67	$100.00	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $63.10 / $190.55	Professional	26	$33.11	$63.10	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $169.82	Professional	TC	$25.12	$43.65	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $239.88 / $316.23	Professional		$87.10	$239.88	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $100.00 / $131.83	Professional	26	$51.29	$100.00	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $141.25 / $194.98	Professional	TC	$36.31	$141.25	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $371.54	Professional		$32.36	$33.11	$371.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $269.15 / $616.60	Facility		$229.09	$269.15	$616.60
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $416.87	Professional		$83.18	$123.03	$416.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $70.79 / $177.83	Professional	26	$47.86	$70.79	$177.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $239.88	Professional	TC	$35.48	$51.29	$239.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $138.04	Professional		$64.57	$104.71	$138.04
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $79.43	Professional	26	$36.31	$60.26	$79.43
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $43.65 / $56.23	Professional	TC	$27.54	$43.65	$56.23
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.10 / $125.89	Professional		$38.90	$63.10	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $4,466.84 / $5,128.61	Facility		$1,071.52	$4,466.84	$5,128.61
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $295.12	Professional		$60.26	$104.71	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $60.26 / $114.82	Professional	26	$34.67	$60.26	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $44.67 / $173.78	Professional	TC	$26.30	$44.67	$173.78