Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $316.23 / $1,071.52	Professional		$169.82	$316.23	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $186.21	Professional	26	$54.95	$85.11	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $218.78 / $389.05	Professional	TC	$112.20	$218.78	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $309.03 / $416.87	Professional		$169.82	$309.03	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $128.82	Professional	26	$51.29	$72.44	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $213.80 / $331.13	Professional	TC	$109.65	$213.80	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $275.42	Professional		$32.36	$33.11	$275.42
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $338.84 / $436.52	Professional		$251.19	$338.84	$436.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $144.54	Professional	26	$83.18	$112.20	$144.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $223.87 / $295.12	Professional	TC	$165.96	$223.87	$295.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $269.15 / $380.19	Professional		$165.96	$269.15	$380.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $123.03 / $147.91	Professional	26	$57.54	$123.03	$147.91
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $144.54 / $229.09	Professional	TC	$107.15	$144.54	$229.09
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $181.97 / $346.74	Professional		$85.11	$181.97	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $398.11	Professional		$165.96	$213.80	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $54.95 / $107.15	Professional	26	$51.29	$54.95	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $141.25 / $288.40	Professional	TC	$109.65	$141.25	$288.40