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 $199.53 / $426.58 / $1,230.27	Professional		$199.53	$426.58	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $213.80 / $524.81	Professional	26	$97.72	$213.80	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $338.84 / $851.14	Professional	TC	$245.47	$338.84	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $630.96 / $1,230.27	Professional		$331.13	$630.96	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $213.80	Professional	26	$85.11	$123.03	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $446.68 / $1,023.29	Professional	TC	$229.09	$446.68	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $691.83	Professional		$32.36	$33.11	$691.83
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 $489.78 / $630.96 / $1,071.52	Professional		$489.78	$630.96	$1,071.52
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $186.21 / $245.47	Professional	26	$141.25	$186.21	$245.47
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $478.63 / $831.76	Professional	TC	$354.81	$478.63	$831.76
Select Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $537.03 / $1,148.15	Professional		$316.23	$537.03	$1,148.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $234.42 / $275.42	Professional	26	$97.72	$234.42	$275.42
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $302.00 / $478.63	Professional	TC	$223.87	$302.00	$478.63
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $389.05 / $660.69	Professional		$144.54	$389.05	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $954.99	Professional		$338.84	$501.19	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $93.33 / $181.97	Professional	26	$87.10	$93.33	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $724.44	Professional	TC	$245.47	$346.74	$724.44