Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $512.86	Professional		$190.55	$275.42	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $67.61 / $138.04	Professional	26	$50.12	$67.61	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $457.09	Professional	TC	$141.25	$213.80	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $363.08 / $794.33	Professional		$251.19	$363.08	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $131.83	Professional	26	$57.54	$81.28	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $263.03 / $707.95	Professional	TC	$177.83	$263.03	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $512.86	Professional		$32.36	$60.26	$512.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $380.19 / $457.09	Professional		$331.13	$380.19	$457.09
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $323.59	Professional	26	$91.20	$104.71	$323.59
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $281.84 / $316.23	Professional	TC	$239.88	$281.84	$316.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $501.19	Professional		$204.17	$331.13	$501.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $147.91	Professional	26	$57.54	$97.72	$147.91
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $239.88 / $354.81	Professional	TC	$147.91	$239.88	$354.81
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $257.04 / $426.58	Professional		$95.50	$257.04	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $602.56	Professional		$199.53	$309.03	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $107.15	Professional	26	$51.29	$61.66	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $257.04 / $501.19	Professional	TC	$144.54	$257.04	$501.19