Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $501.19	Professional		$85.11	$114.82	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $31.62 / $87.10	Professional	26	$22.91	$31.62	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $75.86 / $158.49	Professional	TC	$61.66	$75.86	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $204.17	Professional		$91.20	$128.82	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $37.15 / $54.95	Professional	26	$25.70	$37.15	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $91.20 / $144.54	Professional	TC	$67.61	$91.20	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $204.17	Professional		$32.36	$33.11	$204.17
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 $151.36 / $177.83 / $218.78	Professional		$151.36	$177.83	$218.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $44.67 / $58.88	Professional	26	$36.31	$44.67	$58.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $134.90 / $165.96	Professional	TC	$114.82	$134.90	$165.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $162.18 / $239.88	Professional		$100.00	$162.18	$239.88
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $40.74 / $61.66	Professional	26	$25.12	$40.74	$61.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $123.03 / $177.83	Professional	TC	$75.86	$123.03	$177.83
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $125.89 / $177.83	Professional		$37.15	$125.89	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $190.55	Professional		$95.50	$114.82	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $29.51 / $46.77	Professional	26	$25.70	$29.51	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $87.10 / $144.54	Professional	TC	$69.18	$87.10	$144.54