Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $478.63 / $1,737.80	Professional		$275.42	$478.63	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $141.25 / $239.88	Professional	26	$70.79	$141.25	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $338.84 / $645.65	Professional	TC	$204.17	$338.84	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $457.09 / $645.65	Professional		$257.04	$457.09	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $169.82	Professional	26	$58.88	$85.11	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $363.08 / $524.81	Professional	TC	$190.55	$363.08	$524.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $446.68	Professional		$32.36	$33.11	$446.68
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $691.83	Professional		$389.05	$524.81	$691.83
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $128.82 / $169.82	Professional	26	$97.72	$128.82	$169.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $389.05 / $524.81	Professional	TC	$288.40	$389.05	$524.81
Select Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $407.38 / $741.31	Professional		$245.47	$407.38	$741.31
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $162.18 / $190.55	Professional	26	$66.07	$162.18	$190.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $245.47 / $389.05	Professional	TC	$181.97	$245.47	$389.05
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $316.23 / $512.86	Professional		$97.72	$316.23	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $331.13 / $645.65	Professional		$269.15	$331.13	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $64.57 / $125.89	Professional	26	$60.26	$64.57	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $251.19 / $501.19	Professional	TC	$204.17	$251.19	$501.19