Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $512.86	Professional		$91.20	$169.82	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $74.13 / $229.09	Professional	26	$41.69	$74.13	$229.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $186.21 / $630.96	Professional	52	$43.65	$186.21	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $75.86 / $190.55	Professional	TC	$45.71	$75.86	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $218.78 / $281.84	Professional		$131.83	$218.78	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $117.49	Professional	26	$61.66	$87.10	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $134.90 / $173.78	Professional	TC	$75.86	$134.90	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $165.96 / $338.84	Professional		$100.00	$165.96	$338.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $77.62 / $131.83	Professional	26	$46.77	$77.62	$131.83
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $83.18 / $213.80	Professional	TC	$52.48	$83.18	$213.80
Select Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $288.40	Professional		$97.72	$147.91	$288.40
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $114.82	Professional	26	$43.65	$67.61	$114.82
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $173.78	Professional	TC	$53.70	$79.43	$173.78
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $194.98	Professional		$58.88	$95.50	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $295.12	Professional		$100.00	$169.82	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $64.57 / $95.50	Professional	26	$40.74	$64.57	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $104.71 / $173.78	Professional	TC	$58.88	$104.71	$173.78