Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	26	$40.74	$40.74	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $416.87	Professional		$77.62	$109.65	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $109.65	Professional	26	$30.20	$40.74	$109.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $234.42 / $741.31	Professional	50	$46.77	$234.42	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $70.79 / $134.90	Professional	TC	$56.23	$70.79	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $204.17	Professional		$100.00	$138.04	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $72.44	Professional	26	$33.88	$48.98	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $89.13 / $134.90	Professional	TC	$64.57	$89.13	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $102.33	Professional		$32.36	$33.11	$102.33
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 $144.54 / $186.21 / $223.87	Professional		$144.54	$186.21	$223.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $66.07 / $79.43	Professional	26	$47.86	$66.07	$79.43
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $123.03 / $144.54	Professional	TC	$95.50	$123.03	$144.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $229.09	Professional		$95.50	$158.49	$229.09
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $54.95 / $81.28	Professional	26	$33.11	$54.95	$81.28
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $102.33 / $147.91	Professional	TC	$63.10	$102.33	$147.91
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $104.71 / $173.78	Professional		$50.12	$104.71	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $181.97	Professional		$100.00	$109.65	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $37.15 / $61.66	Professional	26	$34.67	$37.15	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $72.44 / $120.23	Professional	TC	$67.61	$72.44	$120.23