Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $478.63 / $1,949.84	Professional		$309.03	$478.63	$1,949.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $158.49 / $323.59	Professional	26	$109.65	$158.49	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $309.03 / $537.03	Professional	TC	$186.21	$309.03	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $831.76	Professional		$446.68	$501.19	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $208.93 / $281.84	Professional	26	$181.97	$208.93	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $275.42 / $549.54	Professional	TC	$245.47	$275.42	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $645.65	Professional		$32.36	$60.26	$645.65
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $616.60 / $616.60	Facility	26	$616.60	$616.60	$616.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $691.83 / $758.58	Professional		$645.65	$691.83	$758.58
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $263.03 / $316.23	Professional	26	$223.87	$263.03	$316.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $407.38 / $512.86	Professional	TC	$380.19	$407.38	$512.86
Select Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $741.31 / $870.96	Professional		$426.58	$741.31	$870.96
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $281.84 / $338.84	Professional	26	$144.54	$281.84	$338.84
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $489.78 / $575.44	Professional	TC	$281.84	$489.78	$575.44
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $489.78 / $812.83	Professional		$234.42	$489.78	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $524.81 / $812.83	Professional		$416.87	$524.81	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $190.55 / $263.03	Professional	26	$177.83	$190.55	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $316.23 / $524.81	Professional	TC	$239.88	$316.23	$524.81