Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $112.20 / $323.59	Facility	26	$56.23	$112.20	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $213.80 / $831.76	Professional		$100.00	$213.80	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $54.95 / $162.18	Professional	26	$37.15	$54.95	$162.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	52	$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $177.83 / $489.78	Professional	TC	$89.13	$177.83	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $251.19 / $380.19	Professional		$128.82	$251.19	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $112.20	Professional	26	$42.66	$63.10	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $169.82 / $295.12	Professional	TC	$79.43	$169.82	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $281.84	Professional		$32.36	$33.11	$281.84
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $398.11	Professional		$190.55	$257.04	$398.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $114.82	Professional	26	$70.79	$93.33	$114.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $162.18 / $288.40	Professional	TC	$120.23	$162.18	$288.40
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $208.93 / $323.59	Professional		$125.89	$208.93	$323.59
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $104.71 / $125.89	Professional	26	$48.98	$104.71	$125.89
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $104.71 / $165.96	Professional	TC	$77.62	$104.71	$165.96
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $141.25 / $269.15	Professional		$72.44	$141.25	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $190.55 / $380.19	Professional		$138.04	$190.55	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $97.72	Professional	26	$42.66	$50.12	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $123.03 / $239.88	Professional	TC	$87.10	$123.03	$239.88