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 $338.84 / $478.63 / $2,187.76	Professional		$338.84	$478.63	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $120.23 / $269.15	Professional	26	$85.11	$120.23	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $794.33	Professional	TC	$257.04	$338.84	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $776.25	Professional		$323.59	$549.54	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $186.21	Professional	26	$72.44	$104.71	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $416.87 / $660.69	Professional	TC	$245.47	$416.87	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $549.54	Professional		$32.36	$33.11	$549.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $891.25	Professional		$489.78	$660.69	$891.25
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $154.88 / $208.93	Professional	26	$117.49	$154.88	$208.93
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $501.19 / $676.08	Professional	TC	$371.54	$501.19	$676.08
Select Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $954.99	Professional		$323.59	$524.81	$954.99
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $199.53 / $234.42	Professional	26	$81.28	$199.53	$234.42
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $323.59 / $512.86	Professional	TC	$239.88	$323.59	$512.86
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $407.38 / $660.69	Professional		$120.23	$407.38	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $707.95	Professional		$331.13	$416.87	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $77.62 / $151.36	Professional	26	$74.13	$77.62	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $331.13 / $602.56	Professional	TC	$257.04	$331.13	$602.56