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 $234.42 / $426.58 / $707.95	Professional		$234.42	$426.58	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $91.20 / $199.53	Professional	26	$57.54	$91.20	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $537.03	Professional	TC	$177.83	$302.00	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $478.63 / $758.58	Professional		$218.78	$478.63	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $69.18 / $158.49	Professional	26	$47.86	$69.18	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $371.54 / $676.08	Professional	TC	$165.96	$371.54	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $489.78	Professional		$32.36	$33.11	$489.78
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $676.08 / $676.08 / $676.08	Facility	26	$676.08	$676.08	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $831.76	Professional		$331.13	$446.68	$831.76
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $104.71 / $138.04	Professional	26	$79.43	$104.71	$138.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $691.83	Professional	TC	$251.19	$338.84	$691.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $346.74 / $758.58	Professional		$213.80	$346.74	$758.58
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $131.83 / $154.88	Professional	26	$53.70	$131.83	$154.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $346.74	Professional	TC	$162.18	$218.78	$346.74
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $281.84 / $467.74	Professional		$79.43	$281.84	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $363.08 / $616.60	Professional		$218.78	$363.08	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $102.33	Professional	26	$48.98	$52.48	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $288.40 / $524.81	Professional	TC	$169.82	$288.40	$524.81