Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $575.44 / $575.44	Facility	26	$128.82	$575.44	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $478.63 / $1,513.56	Professional		$245.47	$478.63	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $147.91 / $281.84	Professional	26	$69.18	$147.91	$281.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional	52	$1,513.56	$1,513.56	$1,513.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $338.84 / $616.60	Professional	TC	$177.83	$338.84	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $489.78 / $741.31	Professional		$223.87	$489.78	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $169.82	Professional	26	$58.88	$85.11	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $346.74 / $630.96	Professional	TC	$154.88	$346.74	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $501.19	Professional		$32.36	$33.11	$501.19
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 / $794.33	Professional		$331.13	$446.68	$794.33
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $128.82 / $169.82	Professional	26	$95.50	$128.82	$169.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $323.59 / $630.96	Professional	TC	$239.88	$323.59	$630.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $363.08 / $776.25	Professional		$218.78	$363.08	$776.25
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $158.49 / $190.55	Professional	26	$66.07	$158.49	$190.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $204.17 / $323.59	Professional	TC	$151.36	$204.17	$323.59
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $263.03 / $446.68	Professional		$97.72	$263.03	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $645.65	Professional		$229.09	$346.74	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $63.10 / $125.89	Professional	26	$58.88	$63.10	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $263.03 / $478.63	Professional	TC	$165.96	$263.03	$478.63