Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $275.42	Professional		$75.86	$112.20	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.05 / $43.65	Professional	26	$14.13	$19.05	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $93.33 / $190.55	Professional	TC	$60.26	$93.33	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $125.89 / $213.80	Professional		$74.13	$125.89	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.70 / $40.74	Professional	26	$17.78	$25.70	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $97.72 / $169.82	Professional	TC	$53.70	$97.72	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $107.15	Professional		$32.36	$33.11	$107.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $223.87	Professional		$165.96	$194.98	$223.87
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $44.67	Professional	26	$26.92	$33.88	$44.67
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $154.88 / $186.21	Professional	TC	$138.04	$154.88	$186.21
Select Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $229.09	Professional		$104.71	$165.96	$229.09
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $29.51 / $42.66	Professional	26	$18.20	$29.51	$42.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $123.03 / $169.82	Professional	TC	$87.10	$123.03	$169.82
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $128.82 / $213.80	Professional		$26.92	$128.82	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $181.97	Professional		$74.13	$104.71	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $19.50 / $32.36	Professional	26	$17.38	$19.50	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $87.10 / $151.36	Professional	TC	$54.95	$87.10	$151.36