Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	26	$28.84	$28.84	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $288.40	Professional		$81.28	$104.71	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.84 / $70.79	Professional	26	$22.91	$28.84	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $77.62 / $144.54	Professional	TC	$47.86	$77.62	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $204.17	Professional		$89.13	$120.23	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $54.95	Professional	26	$25.12	$35.48	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $83.18 / $141.25	Professional	TC	$64.57	$83.18	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
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 $141.25 / $173.78 / $218.78	Professional		$141.25	$173.78	$218.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $48.98 / $58.88	Professional	26	$37.15	$48.98	$58.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $123.03 / $158.49	Professional	TC	$102.33	$123.03	$158.49
Select Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $199.53	Professional		$91.20	$151.36	$199.53
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $41.69 / $61.66	Professional	26	$24.55	$41.69	$61.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $109.65 / $141.25	Professional	TC	$66.07	$109.65	$141.25
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $114.82 / $186.21	Professional		$37.15	$114.82	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $97.72 / $173.78	Professional		$87.10	$97.72	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.18 / $46.77	Professional	26	$25.12	$28.18	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $70.79 / $125.89	Professional	TC	$61.66	$70.79	$125.89