Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $371.54 / $676.08	Professional		$239.88	$371.54	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $190.55	Professional	26	$70.79	$93.33	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $245.47 / $512.86	Professional	TC	$158.49	$245.47	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $691.83	Professional		$281.84	$478.63	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $181.97	Professional	26	$72.44	$100.00	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $354.81 / $549.54	Professional	TC	$194.98	$354.81	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $467.74	Professional		$32.36	$33.11	$467.74
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $812.83	Professional		$446.68	$575.44	$812.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $154.88 / $208.93	Professional	26	$117.49	$154.88	$208.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $407.38 / $616.60	Professional	TC	$323.59	$407.38	$616.60
Select Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $457.09 / $660.69	Professional		$251.19	$457.09	$660.69
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $173.78 / $204.17	Professional	26	$81.28	$173.78	$204.17
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $446.68	Professional	TC	$169.82	$281.84	$446.68
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $346.74 / $602.56	Professional		$123.03	$346.74	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $380.19 / $645.65	Professional		$263.03	$380.19	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $79.43 / $151.36	Professional	26	$74.13	$79.43	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $269.15 / $467.74	Professional	TC	$194.98	$269.15	$467.74