Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $316.23 / $616.60	Facility		$83.18	$316.23	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $50.12 / $79.43	Facility	26	$10.96	$50.12	$79.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $87.10 / $331.13 / $426.58	Facility	TC	$87.10	$331.13	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $48.98 / $151.36	Professional		$12.59	$48.98	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $17.38 / $46.77	Professional	26	$8.32	$17.38	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $89.13 / $204.17	Professional	50	$19.05	$89.13	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $44.67 / $107.15	Professional	TC	$25.12	$44.67	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $112.20 / $354.81	Facility		$42.66	$112.20	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $85.11	Professional		$33.88	$47.86	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.59 / $19.50	Professional	26	$8.71	$12.59	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $61.66	Professional	TC	$23.99	$34.67	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $33.11 / $64.57	Professional		$16.22	$33.11	$64.57
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 $57.54 / $70.79 / $83.18	Professional		$57.54	$70.79	$83.18
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $23.44	Professional	26	$12.59	$16.60	$23.44
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $60.26	Professional	TC	$44.67	$52.48	$60.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $61.66 / $83.18	Professional		$38.90	$61.66	$83.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $21.38	Professional	26	$8.91	$14.13	$21.38
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $47.86 / $57.54	Professional	TC	$30.20	$47.86	$57.54
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $45.71 / $79.43	Professional		$12.88	$45.71	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $38.90 / $66.07	Professional		$33.88	$38.90	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.77 / $16.22	Professional	26	$8.71	$9.77	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $30.20 / $50.12	Professional	TC	$25.12	$30.20	$50.12