Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $100.00	Facility	26	$19.95	$93.33	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $251.19	Professional		$53.70	$75.86	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.12 / $97.72	Professional	26	$15.85	$25.12	$97.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $199.53 / $199.53 / $199.53	Professional	50	$199.53	$199.53	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $45.71 / $95.50	Professional	TC	$37.15	$45.71	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $81.28 / $131.83	Professional		$70.79	$81.28	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.30 / $40.74	Professional	26	$21.88	$26.30	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $54.95 / $91.20	Professional	TC	$47.86	$54.95	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $117.49	Professional		$67.61	$91.20	$117.49
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.18 / $39.81	Professional	26	$19.05	$28.18	$39.81
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $64.57 / $77.62	Professional	TC	$47.86	$64.57	$77.62
Select Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $117.49	Professional		$61.66	$95.50	$117.49
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $29.51 / $39.81	Professional	26	$17.78	$29.51	$39.81
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $66.07 / $77.62	Professional	TC	$42.66	$66.07	$77.62
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $61.66 / $109.65	Professional		$24.55	$61.66	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $102.33	Professional		$54.95	$69.18	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.38 / $31.62	Professional	26	$16.60	$21.38	$31.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $48.98 / $69.18	Professional	TC	$38.02	$48.98	$69.18