Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $323.59 / $1,380.38	Professional		$218.78	$323.59	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $95.50 / $194.98	Professional	26	$66.07	$95.50	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $457.09	Professional	TC	$144.54	$218.78	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $371.54 / $537.03	Professional		$213.80	$371.54	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $162.18	Professional	26	$64.57	$89.13	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $263.03 / $426.58	Professional	TC	$141.25	$263.03	$426.58
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 $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $416.87 / $616.60	Professional		$323.59	$416.87	$616.60
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $165.96	Professional	26	$107.15	$141.25	$165.96
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $288.40 / $446.68	Professional	TC	$213.80	$288.40	$446.68
Select Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $489.78	Professional		$208.93	$338.84	$489.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $154.88 / $181.97	Professional	26	$72.44	$154.88	$181.97
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $186.21 / $295.12	Professional	TC	$138.04	$186.21	$295.12
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $239.88 / $436.52	Professional		$107.15	$239.88	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $478.63	Professional		$213.80	$295.12	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $131.83	Professional	26	$60.26	$70.79	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $199.53 / $331.13	Professional	TC	$141.25	$199.53	$331.13