Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $208.93 / $478.63	Professional		$107.15	$208.93	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $58.88 / $141.25	Professional	26	$30.90	$58.88	$141.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $48.98 / $69.18 / $169.82	Professional	52	$48.98	$69.18	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $97.72 / $213.80	Professional	TC	$72.44	$97.72	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $218.78	Professional		$102.33	$147.91	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $44.67 / $69.18	Professional	26	$32.36	$44.67	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $104.71 / $165.96	Professional	TC	$64.57	$104.71	$165.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
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 $165.96 / $218.78 / $257.04	Professional		$165.96	$218.78	$257.04
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $61.66 / $75.86	Professional	26	$45.71	$61.66	$75.86
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $151.36 / $181.97	Professional	TC	$123.03	$151.36	$181.97
Select Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $263.03	Professional		$112.20	$181.97	$263.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $52.48 / $77.62	Professional	26	$31.62	$52.48	$77.62
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $128.82 / $181.97	Professional	TC	$79.43	$128.82	$181.97
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $120.23 / $194.98	Professional		$46.77	$120.23	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $125.89 / $208.93	Professional		$112.20	$125.89	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $35.48 / $58.88	Professional	26	$32.36	$35.48	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $89.13 / $147.91	Professional	TC	$81.28	$89.13	$147.91