Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $3,019.95 / $4,570.88	Facility		$204.17	$3,019.95	$4,570.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Facility	26	$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $446.68	Professional		$134.90	$194.98	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $48.98 / $208.93	Professional	26	$37.15	$48.98	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $151.36 / $281.84	Professional	TC	$87.10	$151.36	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $398.11	Professional		$134.90	$190.55	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $56.23 / $85.11	Professional	26	$46.77	$56.23	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $144.54 / $269.15	Professional	TC	$87.10	$144.54	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $234.42	Professional		$32.36	$33.11	$234.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $239.88 / $457.09	Professional		$186.21	$239.88	$457.09
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $194.98	Professional	26	$51.29	$74.13	$194.98
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $144.54 / $245.47	Professional	TC	$117.49	$144.54	$245.47
Select Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $295.12 / $323.59	Professional		$147.91	$295.12	$323.59
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $72.44 / $85.11	Professional	26	$38.90	$72.44	$85.11
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $199.53 / $234.42	Professional	TC	$109.65	$199.53	$234.42
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $199.53 / $302.00	Professional		$58.88	$199.53	$302.00
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 $134.90 / $169.82 / $331.13	Professional		$134.90	$169.82	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $81.28	Professional	26	$38.02	$50.12	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $125.89 / $251.19	Professional	TC	$89.13	$125.89	$251.19