Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,258.93 / $2,511.89	Facility		$501.19	$1,258.93	$2,511.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $138.04 / $933.25	Facility	26	$66.07	$138.04	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $263.03 / $870.96	Professional		$173.78	$263.03	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $269.15	Professional	26	$57.54	$74.13	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $169.82 / $398.11	Professional	TC	$114.82	$169.82	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $295.12 / $436.52	Professional		$234.42	$295.12	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $147.91	Professional	26	$75.86	$95.50	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $288.40	Professional	TC	$144.54	$204.17	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,230.27	Professional		$32.36	$33.11	$1,230.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $933.25 / $2,137.96	Facility		$794.33	$933.25	$2,137.96
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $870.96 / $870.96 / $870.96	Facility	26	$870.96	$870.96	$870.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $416.87 / $2,398.83	Professional		$295.12	$416.87	$2,398.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $141.25 / $977.24	Professional	26	$100.00	$141.25	$977.24
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $281.84 / $1,380.38	Professional	TC	$190.55	$281.84	$1,380.38
Select Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $407.38	Professional		$186.21	$302.00	$407.38
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $107.15 / $151.36	Professional	26	$66.07	$107.15	$151.36
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $190.55 / $257.04	Professional	TC	$120.23	$190.55	$257.04
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $199.53 / $354.81	Professional		$93.33	$199.53	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $371.54	Professional		$181.97	$257.04	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $79.43 / $125.89	Professional	26	$60.26	$79.43	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $165.96 / $269.15	Professional	TC	$117.49	$165.96	$269.15