Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $389.05 / $831.76	Facility		$100.00	$389.05	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $190.55 / $234.42	Facility	26	$39.81	$190.55	$234.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $208.93 / $489.78 / $707.95	Facility	TC	$208.93	$489.78	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $645.65	Professional		$95.50	$154.88	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $45.71 / $134.90	Professional	26	$21.88	$45.71	$134.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	52	$181.97	$181.97	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $85.11 / $208.93	Professional	TC	$61.66	$85.11	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $190.55 / $436.52	Facility		$100.00	$190.55	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $234.42	Professional		$109.65	$147.91	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $48.98 / $74.13	Professional	26	$35.48	$48.98	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $100.00 / $162.18	Professional	TC	$72.44	$100.00	$162.18
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 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 Facility Modifier TC Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	TC	$199.53	$199.53	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $354.81	Professional		$151.36	$204.17	$354.81
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $67.61 / $120.23	Professional	26	$48.98	$67.61	$120.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $141.25 / $234.42	Professional	TC	$102.33	$141.25	$234.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $239.88	Professional		$102.33	$165.96	$239.88
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 $67.61 / $109.65 / $158.49	Professional	TC	$67.61	$109.65	$158.49
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $112.20 / $204.17	Professional		$50.12	$112.20	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $120.23 / $190.55	Professional		$109.65	$120.23	$190.55
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 $72.44 / $81.28 / $131.83	Professional	TC	$72.44	$81.28	$131.83