Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $426.58	Professional		$173.78	$213.80	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $302.00	Professional	26	$41.69	$53.70	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $316.23	Professional	TC	$131.83	$165.96	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $588.84	Professional		$190.55	$275.42	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $64.57 / $114.82	Professional	26	$43.65	$64.57	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $338.84	Professional	TC	$144.54	$204.17	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $501.19	Professional		$32.36	$33.11	$501.19
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $489.78	Professional		$295.12	$398.11	$489.78
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $95.50 / $123.03	Professional	26	$72.44	$95.50	$123.03
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $295.12 / $371.54	Professional	TC	$223.87	$295.12	$371.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $309.03 / $407.38	Professional		$181.97	$309.03	$407.38
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $81.28 / $123.03	Professional	26	$47.86	$81.28	$123.03
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $229.09 / $269.15	Professional	TC	$134.90	$229.09	$269.15
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $234.42 / $398.11	Professional		$72.44	$234.42	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $204.17 / $389.05	Professional		$190.55	$204.17	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $48.98 / $93.33	Professional	26	$45.71	$48.98	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $154.88 / $295.12	Professional	TC	$147.91	$154.88	$295.12