Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $251.19 / $467.74	Facility	26	$53.70	$251.19	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $501.19	Professional		$95.50	$177.83	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $75.86 / $208.93	Professional	26	$37.15	$75.86	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $70.79 / $162.18	Professional	TC	$56.23	$70.79	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $151.36 / $213.80	Professional		$102.33	$151.36	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $87.10	Professional	26	$40.74	$56.23	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $87.10 / $138.04	Professional	TC	$58.88	$87.10	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
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 $154.88 / $199.53 / $239.88	Professional		$154.88	$199.53	$239.88
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $95.50	Professional	26	$56.23	$75.86	$95.50
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $123.03 / $147.91	Professional	TC	$97.72	$123.03	$147.91
Select Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $239.88	Professional		$107.15	$165.96	$239.88
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $63.10 / $93.33	Professional	26	$39.81	$63.10	$93.33
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $102.33 / $147.91	Professional	TC	$66.07	$102.33	$147.91
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $95.50 / $181.97	Professional		$54.95	$95.50	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $117.49 / $194.98	Professional		$107.15	$117.49	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $43.65 / $72.44	Professional	26	$40.74	$43.65	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $74.13 / $120.23	Professional	TC	$67.61	$74.13	$120.23