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 $239.88 / $478.63 / $1,071.52	Professional		$239.88	$478.63	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $131.83 / $208.93	Professional	26	$64.57	$131.83	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $512.86	Professional	TC	$177.83	$302.00	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $478.63 / $724.44	Professional		$218.78	$478.63	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $162.18	Professional	26	$53.70	$77.62	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $354.81 / $602.56	Professional	TC	$158.49	$354.81	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $478.63	Professional		$32.36	$33.11	$478.63
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 $331.13 / $446.68 / $758.58	Professional		$331.13	$446.68	$758.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $117.49 / $154.88	Professional	26	$89.13	$117.49	$154.88
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $323.59 / $602.56	Professional	TC	$239.88	$323.59	$602.56
Select Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $354.81 / $758.58	Professional		$213.80	$354.81	$758.58
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $147.91 / $173.78	Professional	26	$60.26	$147.91	$173.78
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $208.93 / $331.13	Professional	TC	$151.36	$208.93	$331.13
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $269.15 / $478.63	Professional		$89.13	$269.15	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $346.74 / $645.65	Professional		$223.87	$346.74	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $58.88 / $114.82	Professional	26	$54.95	$58.88	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $251.19 / $489.78	Professional	TC	$165.96	$251.19	$489.78