Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $229.09 / $323.59	Facility		$48.98	$229.09	$323.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $204.17 / $204.17	Facility	26	$57.54	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $83.18 / $173.78	Professional		$44.67	$83.18	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $57.54 / $269.15	Professional	26	$25.70	$57.54	$269.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $83.18 / $177.83 / $346.74	Professional	50	$83.18	$177.83	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.88 / $60.26	Professional	TC	$14.13	$21.88	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $138.04 / $436.52	Facility		$23.99	$138.04	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $91.20 / $162.18	Professional		$54.95	$91.20	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $53.70 / $93.33	Professional	26	$31.62	$53.70	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.02 / $74.13	Professional	TC	$19.95	$38.02	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $302.00	Professional		$32.36	$33.11	$302.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $371.54 / $549.54	Facility		$199.53	$371.54	$549.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $117.49 / $537.03	Professional		$67.61	$117.49	$537.03
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $67.61 / $302.00	Professional	26	$41.69	$67.61	$302.00
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $51.29 / $234.42	Professional	TC	$25.12	$51.29	$234.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $74.13 / $114.82	Professional		$45.71	$74.13	$114.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $47.86 / $69.18	Professional	26	$29.51	$47.86	$69.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.92 / $44.67	Professional	TC	$17.38	$26.92	$44.67
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $51.29 / $107.15	Professional		$25.70	$51.29	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $114.82	Professional		$48.98	$64.57	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $66.07	Professional	26	$30.20	$37.15	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $51.29	Professional	TC	$18.20	$25.12	$51.29