Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $331.13	Professional		$107.15	$134.90	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $22.91 / $53.70	Professional	26	$11.75	$22.91	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $112.20 / $194.98	Professional	TC	$95.50	$112.20	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $223.87 / $309.03	Professional		$144.54	$223.87	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.30 / $43.65	Professional	26	$16.60	$26.30	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $190.55 / $269.15	Professional	TC	$120.23	$190.55	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $208.93 / $295.12	Professional		$158.49	$208.93	$295.12
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $29.51 / $45.71	Professional	26	$20.89	$29.51	$45.71
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $177.83 / $275.42	Professional	TC	$134.90	$177.83	$275.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $257.04 / $380.19	Professional		$117.49	$257.04	$380.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $41.69 / $57.54	Professional	26	$20.89	$41.69	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $213.80 / $316.23	Professional	TC	$97.72	$213.80	$316.23
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $173.78 / $239.88	Professional		$30.90	$173.78	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $181.97 / $288.40	Professional		$134.90	$181.97	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $23.99 / $39.81	Professional	26	$13.80	$23.99	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $158.49 / $251.19	Professional	TC	$112.20	$158.49	$251.19