Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $2,630.27 / $9,772.37	Facility		$251.19	$2,630.27	$9,772.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $169.82 / $338.84	Professional		$70.79	$169.82	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $81.28 / $204.17	Professional	26	$50.12	$81.28	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	52	$134.90	$134.90	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $102.33 / $269.15	Professional	TC	$57.54	$102.33	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $4,073.80 / $12,882.50	Facility		$91.20	$4,073.80	$12,882.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $245.47 / $524.81	Professional		$154.88	$245.47	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $85.11 / $151.36	Professional	26	$61.66	$85.11	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $138.04 / $446.68	Professional	TC	$75.86	$138.04	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $416.87	Professional		$32.36	$33.11	$416.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $9,332.54 / $12,882.50	Facility		$5,248.07	$9,332.54	$12,882.50
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility	26	$5,248.07	$5,248.07	$5,248.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $380.19	Professional		$208.93	$281.84	$380.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $239.88	Professional	26	$112.20	$128.82	$239.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $128.82 / $245.47	Professional	TC	$97.72	$128.82	$245.47
Select Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $229.09 / $354.81	Professional		$138.04	$229.09	$354.81
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $128.82 / $194.98	Professional	26	$75.86	$128.82	$194.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $102.33 / $162.18	Professional	TC	$63.10	$102.33	$162.18
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $398.11	Professional		$93.33	$141.25	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $181.97 / $389.05	Professional		$151.36	$181.97	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $138.04	Professional	26	$54.95	$83.18	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $117.49 / $316.23	Professional	TC	$70.79	$117.49	$316.23