Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $616.60	Professional		$128.82	$169.82	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $229.09	Professional	26	$51.29	$85.11	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $97.72 / $218.78	Professional	TC	$64.57	$97.72	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $331.13	Professional		$123.03	$208.93	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $83.18 / $141.25	Professional	26	$58.88	$83.18	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $112.20 / $239.88	Professional	TC	$64.57	$112.20	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $281.84	Professional		$199.53	$234.42	$281.84
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $138.04	Professional	26	$95.50	$114.82	$138.04
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $123.03 / $144.54	Professional	TC	$100.00	$123.03	$144.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $295.12	Professional		$117.49	$194.98	$295.12
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $109.65 / $165.96	Professional	26	$66.07	$109.65	$165.96
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $87.10 / $125.89	Professional	TC	$52.48	$87.10	$125.89
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $234.42	Professional		$79.43	$114.82	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $263.03	Professional		$107.15	$138.04	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.57 / $114.82	Professional	26	$47.86	$64.57	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $77.62 / $177.83	Professional	TC	$57.54	$77.62	$177.83