Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Facility	26	$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $89.13 / $302.00	Professional		$53.70	$89.13	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $22.39 / $60.26	Professional	26	$12.88	$22.39	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $52.48 / $125.89	Professional	TC	$39.81	$52.48	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $125.89	Professional		$63.10	$85.11	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $22.91 / $33.11	Professional	26	$15.14	$22.91	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $91.20	Professional	TC	$43.65	$54.95	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.11 / $64.57	Professional		$30.90	$33.11	$64.57
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 $87.10 / $109.65 / $138.04	Professional		$87.10	$109.65	$138.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $41.69	Professional	26	$19.95	$26.30	$41.69
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $93.33	Professional	TC	$67.61	$79.43	$93.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $95.50 / $120.23	Professional		$57.54	$95.50	$120.23
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $22.91 / $32.36	Professional	26	$13.80	$22.91	$32.36
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $72.44 / $85.11	Professional	TC	$44.67	$72.44	$85.11
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $70.79 / $117.49	Professional		$20.42	$70.79	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $63.10 / $112.20	Professional		$56.23	$63.10	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $17.78 / $25.70	Professional	26	$14.45	$17.78	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $45.71 / $83.18	Professional	TC	$39.81	$45.71	$83.18