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 $177.83 / $478.63 / $1,584.89	Professional		$177.83	$478.63	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $165.96 / $389.05	Professional	26	$77.62	$165.96	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $346.74 / $758.58	Professional	TC	$251.19	$346.74	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $537.03 / $794.33	Professional		$302.00	$537.03	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $95.50 / $169.82	Professional	26	$66.07	$95.50	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $407.38 / $645.65	Professional	TC	$229.09	$407.38	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $524.81	Professional		$32.36	$33.11	$524.81
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility	26	$1,288.25	$1,288.25	$1,288.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $616.60 / $831.76	Professional		$457.09	$616.60	$831.76
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $144.54 / $186.21	Professional	26	$107.15	$144.54	$186.21
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $478.63 / $645.65	Professional	TC	$354.81	$478.63	$645.65
Select Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $478.63 / $954.99	Professional		$302.00	$478.63	$954.99
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $177.83 / $213.80	Professional	26	$74.13	$177.83	$213.80
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 $109.65 / $380.19 / $645.65	Professional		$109.65	$380.19	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $389.05 / $741.31	Professional		$316.23	$389.05	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $138.04	Professional	26	$66.07	$70.79	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $316.23 / $575.44	Professional	TC	$245.47	$316.23	$575.44