Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $239.88 / $436.52	Facility		$47.86	$239.88	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $61.66 / $66.07	Facility	26	$12.88	$61.66	$66.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $199.53 / $363.08 / $436.52	Facility	TC	$199.53	$363.08	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $162.18	Professional		$35.48	$54.95	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $18.62 / $37.15	Professional	26	$10.00	$18.62	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $40.74 / $95.50	Professional	TC	$23.99	$40.74	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $112.20 / $354.81	Facility		$39.81	$112.20	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.86 / $83.18	Professional		$36.31	$47.86	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.79 / $23.44	Professional	26	$10.47	$14.79	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $56.23	Professional	TC	$24.55	$33.11	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.11 / $60.26	Professional		$19.05	$33.11	$60.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $269.15 / $407.38	Facility		$147.91	$269.15	$407.38
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 $56.23 / $69.18 / $79.43	Professional		$56.23	$69.18	$79.43
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.95 / $27.54	Professional	26	$15.14	$19.95	$27.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $54.95	Professional	TC	$40.74	$47.86	$54.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $60.26 / $79.43	Professional		$37.15	$60.26	$79.43
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $25.70	Professional	26	$10.00	$16.98	$25.70
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $51.29	Professional	TC	$26.92	$43.65	$51.29
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $42.66 / $75.86	Professional		$15.14	$42.66	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $67.61	Professional		$33.11	$38.90	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.48 / $19.05	Professional	26	$10.23	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.92 / $47.86	Professional	TC	$23.44	$26.92	$47.86