Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $213.80 / $416.87	Facility	26	$53.70	$213.80	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $602.56	Professional		$125.89	$218.78	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $100.00 / $213.80	Professional	26	$42.66	$100.00	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $102.33 / $199.53	Professional	TC	$74.13	$102.33	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $269.15	Professional		$131.83	$186.21	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $64.57 / $100.00	Professional	26	$46.77	$64.57	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $112.20 / $177.83	Professional	TC	$85.11	$112.20	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $117.49	Professional		$32.36	$33.11	$117.49
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $302.00	Professional		$190.55	$251.19	$302.00
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $87.10 / $109.65	Professional	26	$66.07	$87.10	$109.65
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $158.49 / $190.55	Professional	TC	$125.89	$158.49	$190.55
Select Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $204.17 / $295.12	Professional		$128.82	$204.17	$295.12
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $74.13 / $109.65	Professional	26	$45.71	$74.13	$109.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $131.83 / $186.21	Professional	TC	$83.18	$131.83	$186.21
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $123.03 / $223.87	Professional		$67.61	$123.03	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $239.88	Professional		$134.90	$144.54	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $51.29 / $83.18	Professional	26	$46.77	$51.29	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $95.50 / $158.49	Professional	TC	$87.10	$95.50	$158.49