Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $489.78	Professional		$81.28	$104.71	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $38.90 / $85.11	Professional	26	$20.89	$38.90	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $72.44 / $141.25	Professional	TC	$56.23	$72.44	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $204.17	Professional		$81.28	$117.49	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $60.26	Professional	26	$24.55	$32.36	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $83.18 / $138.04	Professional	TC	$58.88	$83.18	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $199.53	Professional		$138.04	$169.82	$199.53
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $53.70	Professional	26	$39.81	$47.86	$53.70
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $123.03 / $147.91	Professional	TC	$100.00	$123.03	$147.91
Select Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $147.91 / $190.55	Professional		$87.10	$147.91	$190.55
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $44.67 / $61.66	Professional	26	$26.92	$44.67	$61.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $102.33 / $128.82	Professional	TC	$61.66	$102.33	$128.82
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $97.72 / $186.21	Professional		$39.81	$97.72	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $93.33 / $162.18	Professional		$83.18	$93.33	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $28.84 / $47.86	Professional	26	$22.39	$28.84	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $67.61 / $114.82	Professional	TC	$60.26	$67.61	$114.82