Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $363.08 / $389.05	Facility	26	$128.82	$363.08	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $363.08 / $1,258.93	Professional		$109.65	$363.08	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $144.54 / $371.54	Professional	26	$61.66	$144.54	$371.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $478.63 / $478.63	Professional	50	$478.63	$478.63	$478.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $100.00 / $190.55 / $501.19	Professional	52	$100.00	$190.55	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $338.84 / $891.25	Professional	TC	$154.88	$338.84	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $630.96	Professional		$194.98	$426.58	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $162.18	Professional	26	$54.95	$77.62	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $295.12 / $549.54	Professional	TC	$134.90	$295.12	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $346.74	Professional		$32.36	$33.11	$346.74
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $389.05 / $537.03	Professional		$295.12	$389.05	$537.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $120.23 / $158.49	Professional	26	$89.13	$120.23	$158.49
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $275.42 / $380.19	Professional	TC	$204.17	$275.42	$380.19
Select Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $323.59 / $602.56	Professional		$194.98	$323.59	$602.56
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $147.91 / $302.00	Professional	26	$61.66	$147.91	$302.00
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $177.83 / $281.84	Professional	TC	$131.83	$177.83	$281.84
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $229.09 / $426.58	Professional		$91.20	$229.09	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $645.65	Professional		$199.53	$281.84	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $58.88 / $114.82	Professional	26	$54.95	$58.88	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $181.97 / $457.09	Professional	TC	$138.04	$181.97	$457.09