Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $851.14	Professional		$169.82	$275.42	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $97.72 / $257.04	Professional	26	$51.29	$97.72	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $177.83 / $380.19	Professional	TC	$114.82	$177.83	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $309.03 / $457.09	Professional		$165.96	$309.03	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $125.89	Professional	26	$48.98	$70.79	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $223.87 / $363.08	Professional	TC	$109.65	$223.87	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $363.08	Professional		$32.36	$33.11	$363.08
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 $245.47 / $331.13 / $501.19	Professional		$245.47	$331.13	$501.19
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $141.25	Professional	26	$81.28	$107.15	$141.25
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $218.78 / $363.08	Professional	TC	$165.96	$218.78	$363.08
Select Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $389.05	Professional		$162.18	$263.03	$389.05
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $117.49 / $138.04	Professional	26	$54.95	$117.49	$138.04
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 $81.28 / $186.21 / $338.84	Professional		$81.28	$186.21	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $398.11	Professional		$169.82	$239.88	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $52.48 / $102.33	Professional	26	$50.12	$52.48	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $165.96 / $295.12	Professional	TC	$117.49	$165.96	$295.12