Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $407.38 / $660.69	Facility		$85.11	$407.38	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $204.17 / $204.17	Facility	26	$38.02	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $416.87	Professional		$58.88	$95.50	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $58.88 / $138.04	Professional	26	$30.20	$58.88	$138.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $199.53 / $645.65	Professional	50	$74.13	$199.53	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $57.54 / $239.88	Professional	TC	$43.65	$57.54	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $112.20 / $354.81	Facility		$70.79	$112.20	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $165.96	Professional		$81.28	$114.82	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $45.71 / $67.61	Professional	26	$31.62	$45.71	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $104.71	Professional	TC	$50.12	$67.61	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $77.62	Professional		$32.36	$33.11	$77.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $269.15 / $371.54	Facility		$147.91	$269.15	$371.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $186.21	Professional		$120.23	$154.88	$186.21
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $74.13	Professional	26	$44.67	$61.66	$74.13
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $95.50 / $112.20	Professional	TC	$74.13	$95.50	$112.20
Select Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $186.21	Professional		$79.43	$131.83	$186.21
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $51.29 / $75.86	Professional	26	$30.90	$51.29	$75.86
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $79.43 / $112.20	Professional	TC	$48.98	$79.43	$112.20
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $79.43 / $144.54	Professional		$46.77	$79.43	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $89.13 / $147.91	Professional		$83.18	$89.13	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $34.67 / $57.54	Professional	26	$31.62	$34.67	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $54.95 / $91.20	Professional	TC	$51.29	$54.95	$91.20