Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $81.28 / $81.28	Facility	26	$16.98	$81.28	$81.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $112.20 / $851.14 / $954.99	Facility	TC	$112.20	$851.14	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $63.10 / $158.49	Professional		$43.65	$63.10	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $46.77	Professional	26	$13.18	$19.05	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $42.66 / $93.33	Professional	TC	$30.90	$42.66	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $109.65	Professional		$50.12	$64.57	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $20.42 / $30.90	Professional	26	$13.80	$20.42	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $44.67 / $75.86	Professional	TC	$33.88	$44.67	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $74.13	Professional		$25.70	$33.11	$74.13
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 $75.86 / $93.33 / $104.71	Professional		$75.86	$93.33	$104.71
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.30 / $34.67	Professional	26	$19.50	$26.30	$34.67
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $66.07 / $74.13	Professional	TC	$56.23	$66.07	$74.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $83.18 / $102.33	Professional		$50.12	$83.18	$102.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $22.39 / $30.90	Professional	26	$13.49	$22.39	$30.90
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $60.26 / $70.79	Professional	TC	$37.15	$60.26	$70.79
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $61.66 / $100.00	Professional		$20.42	$61.66	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $52.48 / $87.10	Professional		$46.77	$52.48	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.49 / $25.12	Professional	26	$13.80	$15.49	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $37.15 / $61.66	Professional	TC	$31.62	$37.15	$61.66