Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $316.23 / $562.34	Facility		$85.11	$316.23	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $44.67 / $51.29	Facility	26	$8.91	$44.67	$51.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $89.13 / $363.08 / $524.81	Facility	TC	$89.13	$363.08	$524.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $36.31 / $125.89	Professional		$10.96	$36.31	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.13 / $38.90	Professional	26	$7.76	$14.13	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $151.36 / $186.21	Professional	50	$42.66	$151.36	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.81 / $89.13	Professional	TC	$21.88	$39.81	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $112.20 / $354.81	Facility		$33.11	$112.20	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.65 / $69.18	Professional		$32.36	$43.65	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $18.20	Professional	26	$8.13	$11.48	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $29.51 / $50.12	Professional	TC	$22.39	$29.51	$50.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $33.11 / $60.26	Professional		$14.79	$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 / $60.26 / $74.13	Professional		$46.77	$60.26	$74.13
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.49 / $19.95	Professional	26	$11.75	$15.49	$19.95
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $42.66 / $53.70	Professional	TC	$34.67	$42.66	$53.70
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $69.18	Professional		$30.90	$50.12	$69.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $19.95	Professional	26	$7.94	$13.18	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $37.15 / $46.77	Professional	TC	$22.39	$37.15	$46.77
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $36.31 / $63.10	Professional		$12.02	$36.31	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $58.88	Professional		$29.51	$33.88	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.12 / $14.79	Professional	26	$8.13	$9.12	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $25.12 / $43.65	Professional	TC	$21.38	$25.12	$43.65