Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Facility	26	$14.13	$14.13	$14.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $95.50 / $251.19	Professional		$63.10	$95.50	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $53.70	Professional	26	$10.96	$14.13	$53.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.30 / $87.10 / $229.09	Professional	52	$26.30	$87.10	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $91.20 / $158.49	Professional	TC	$63.10	$91.20	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $169.82	Professional		$91.20	$123.03	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.60 / $25.70	Professional	26	$12.30	$16.60	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $107.15 / $144.54	Professional	TC	$79.43	$107.15	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $158.49	Professional		$93.33	$120.23	$158.49
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.38 / $23.44	Professional	26	$13.49	$17.38	$23.44
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $102.33 / $134.90	Professional	TC	$79.43	$102.33	$134.90
Select Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $144.54 / $208.93	Professional		$79.43	$144.54	$208.93
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $21.38 / $32.36	Professional	26	$11.48	$21.38	$32.36
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $123.03 / $173.78	Professional	TC	$67.61	$123.03	$173.78
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $97.72 / $147.91	Professional		$15.85	$97.72	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $173.78	Professional		$74.13	$104.71	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.13 / $22.39	Professional	26	$10.72	$14.13	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $91.20 / $147.91	Professional	TC	$63.10	$91.20	$147.91