Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $112.20 / $338.84	Facility	26	$40.74	$112.20	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $575.44	Professional		$112.20	$194.98	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $51.29 / $147.91	Professional	26	$32.36	$51.29	$147.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.88 / $77.62 / $575.44	Professional	52	$33.88	$77.62	$575.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $104.71 / $269.15	Professional	TC	$81.28	$104.71	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $263.03	Professional		$128.82	$177.83	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $75.86	Professional	26	$33.88	$48.98	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $190.55	Professional	TC	$91.20	$123.03	$190.55
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 $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $229.09 / $281.84	Professional		$177.83	$229.09	$281.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $81.28	Professional	26	$50.12	$66.07	$81.28
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $165.96 / $204.17	Professional	TC	$128.82	$165.96	$204.17
Select Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $263.03	Professional		$117.49	$194.98	$263.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $57.54 / $85.11	Professional	26	$33.88	$57.54	$85.11
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $181.97	Professional	TC	$83.18	$141.25	$181.97
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $144.54 / $239.88	Professional		$51.29	$144.54	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $154.88 / $229.09	Professional		$125.89	$154.88	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $42.66 / $64.57	Professional	26	$37.15	$42.66	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $109.65 / $165.96	Professional	TC	$93.33	$109.65	$165.96