Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $223.87 / $478.63	Facility		$40.74	$223.87	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.02 / $12.02	Facility	26	$12.02	$12.02	$12.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $489.78 / $812.83	Facility	TC	$28.18	$489.78	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $47.86 / $158.49	Professional		$34.67	$47.86	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.45 / $38.02	Professional	26	$8.91	$14.45	$38.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.02 / $177.83	Professional	50	$38.02	$38.02	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $32.36 / $77.62	Professional	TC	$25.12	$32.36	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $138.04 / $436.52	Facility		$41.69	$138.04	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $85.11	Professional		$36.31	$51.29	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $23.44	Professional	26	$10.72	$15.49	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $60.26	Professional	TC	$26.92	$36.31	$60.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $66.07	Professional		$28.18	$33.11	$66.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $389.05 / $549.54	Facility		$199.53	$389.05	$549.54
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 Facility Modifier TC Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	TC	$199.53	$199.53	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $85.11	Professional		$57.54	$72.44	$85.11
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.95 / $26.30	Professional	26	$15.14	$19.95	$26.30
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $58.88	Professional	TC	$42.66	$53.70	$58.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.10 / $77.62	Professional		$38.90	$63.10	$77.62
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.98 / $23.99	Professional	26	$10.23	$16.98	$23.99
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $46.77 / $54.95	Professional	TC	$28.18	$46.77	$54.95
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $47.86 / $75.86	Professional		$15.49	$47.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $40.74 / $67.61	Professional		$36.31	$40.74	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $11.75 / $19.05	Professional	26	$10.72	$11.75	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $28.84 / $47.86	Professional	TC	$26.30	$28.84	$47.86