Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Facility	26	$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $234.42	Professional		$81.28	$123.03	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $46.77 / $263.03	Professional	26	$18.20	$46.77	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $70.79 / $199.53	Professional	TC	$42.66	$70.79	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $426.58	Professional		$100.00	$158.49	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $34.67 / $81.28	Professional	26	$19.95	$34.67	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $93.33 / $380.19	Professional	TC	$57.54	$93.33	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $204.17	Professional		$32.36	$33.11	$204.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $208.93	Professional		$134.90	$165.96	$208.93
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $72.44 / $87.10	Professional	26	$39.81	$72.44	$87.10
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $95.50 / $165.96	Professional	TC	$72.44	$95.50	$165.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $229.09	Professional		$89.13	$147.91	$229.09
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $72.44 / $109.65	Professional	26	$42.66	$72.44	$109.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $75.86 / $123.03	Professional	TC	$46.77	$75.86	$123.03
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $208.93	Professional		$64.57	$91.20	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $295.12	Professional		$87.10	$114.82	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $38.90 / $77.62	Professional	26	$17.78	$38.90	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $81.28 / $263.03	Professional	TC	$56.23	$81.28	$263.03