Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $194.98 / $389.05	Facility		$85.11	$194.98	$389.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $66.07 / $69.18	Facility	26	$12.02	$66.07	$69.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $154.88 / $316.23 / $398.11	Facility	TC	$154.88	$316.23	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $43.65 / $128.82	Professional		$28.18	$43.65	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.45 / $43.65	Professional	26	$8.91	$14.45	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.18 / $83.18	Professional	TC	$17.78	$28.18	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $158.49 / $354.81	Facility		$31.62	$158.49	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $69.18	Professional		$31.62	$41.69	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.45 / $22.91	Professional	26	$10.00	$14.45	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $44.67	Professional	TC	$19.95	$26.30	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $60.26	Professional		$23.99	$33.11	$60.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $251.19 / $302.00	Facility		$147.91	$251.19	$302.00
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Regence BlueShield Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	TC	$147.91	$147.91	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $66.07	Professional		$46.77	$57.54	$66.07
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.05 / $23.99	Professional	26	$14.45	$19.05	$23.99
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $37.15 / $43.65	Professional	TC	$33.11	$37.15	$43.65
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $67.61	Professional		$30.90	$51.29	$67.61
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.60 / $23.44	Professional	26	$9.55	$16.60	$23.44
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $35.48 / $41.69	Professional	TC	$20.89	$35.48	$41.69
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $36.31 / $61.66	Professional		$14.79	$36.31	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $32.36 / $54.95	Professional		$29.51	$32.36	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $11.22 / $18.62	Professional	26	$10.00	$11.22	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $21.88 / $36.31	Professional	TC	$18.62	$21.88	$36.31