Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $288.40 / $549.54	Facility		$83.18	$288.40	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $51.29 / $66.07	Facility	26	$8.91	$51.29	$66.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $194.98 / $346.74 / $426.58	Facility	TC	$194.98	$346.74	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $40.74 / $125.89	Professional		$10.47	$40.74	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.79 / $43.65	Professional	26	$7.94	$14.79	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $91.20 / $186.21	Professional	50	$42.66	$91.20	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $114.82	Professional	TC	$22.91	$41.69	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $112.20 / $354.81	Facility		$38.02	$112.20	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $75.86	Professional		$30.90	$42.66	$75.86
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 $21.88 / $30.90 / $53.70	Professional	TC	$21.88	$30.90	$53.70
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 $51.29 / $63.10 / $74.13	Professional		$51.29	$63.10	$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 $39.81 / $46.77 / $53.70	Professional	TC	$39.81	$46.77	$53.70
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $77.62	Professional		$33.88	$56.23	$77.62
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 $26.30 / $42.66 / $50.12	Professional	TC	$26.30	$42.66	$50.12
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $39.81 / $70.79	Professional		$12.02	$39.81	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $58.88	Professional		$30.20	$34.67	$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 $22.39 / $26.30 / $43.65	Professional	TC	$22.39	$26.30	$43.65