Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,238.72 / $10,232.93	Professional		$1,737.80	$2,238.72	$10,232.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $707.95 / $1,737.80	Professional	26	$371.54	$707.95	$1,737.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.93 / $1,778.28 / $3,311.31	Professional	TC	$1,258.93	$1,778.28	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,630.27 / $3,388.44	Professional		$1,778.28	$2,630.27	$3,388.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $501.19 / $549.54 / $741.31	Professional	26	$501.19	$549.54	$741.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $2,137.96 / $2,754.23	Professional	TC	$1,348.96	$2,137.96	$2,754.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $3,467.37	Professional		$32.36	$60.26	$3,467.37
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	26	$2,290.87	$2,290.87	$2,290.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,548.13 / $3,981.07	Professional		$2,754.23	$3,548.13	$3,981.07
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $616.60 / $724.44 / $870.96	Professional	26	$616.60	$724.44	$870.96
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $2,137.96 / $2,454.71 / $3,019.95	Professional	TC	$2,137.96	$2,454.71	$3,019.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $3,311.31 / $4,168.69	Professional		$1,819.70	$3,311.31	$4,168.69
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $398.11 / $776.25 / $933.25	Professional	26	$398.11	$776.25	$933.25
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,412.54 / $2,511.89 / $3,162.28	Professional	TC	$1,412.54	$2,511.89	$3,162.28
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $2,137.96 / $3,388.44	Professional		$602.56	$2,137.96	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,454.71 / $3,311.31	Professional		$1,949.84	$2,454.71	$3,311.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $457.09 / $524.81 / $724.44	Professional	26	$457.09	$524.81	$724.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,698.24 / $1,995.26 / $2,630.27	Professional	TC	$1,698.24	$1,995.26	$2,630.27