Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $575.44 / $831.76	Facility		$104.71	$575.44	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $234.42 / $234.42	Facility	26	$43.65	$234.42	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $186.21 / $630.96	Professional		$102.33	$186.21	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.48 / $162.18	Professional	26	$34.67	$52.48	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $102.33 / $295.12	Professional	TC	$67.61	$102.33	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $190.55 / $436.52	Facility		$104.71	$190.55	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $162.18 / $245.47	Professional		$117.49	$162.18	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $79.43	Professional	26	$38.90	$53.70	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $107.15 / $165.96	Professional	TC	$75.86	$107.15	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $389.05 / $549.54	Facility		$199.53	$389.05	$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 $162.18 / $218.78 / $281.84	Professional		$162.18	$218.78	$281.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $87.10	Professional	26	$52.48	$70.79	$87.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $147.91 / $194.98	Professional	TC	$109.65	$147.91	$194.98
Select Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $263.03	Professional		$109.65	$177.83	$263.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $91.20	Professional	26	$36.31	$60.26	$91.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $117.49 / $169.82	Professional	TC	$72.44	$117.49	$169.82
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $112.20 / $199.53	Professional		$54.95	$112.20	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $208.93	Professional		$117.49	$131.83	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $41.69 / $69.18	Professional	26	$38.02	$41.69	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $87.10 / $138.04	Professional	TC	$79.43	$87.10	$138.04