Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Facility	26	$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $323.59 / $467.74	Professional		$257.04	$323.59	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $114.82	Professional	26	$41.69	$54.95	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $275.42 / $407.38	Professional	TC	$213.80	$275.42	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $691.83	Professional		$346.74	$446.68	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $70.79 / $107.15	Professional	26	$57.54	$70.79	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $371.54 / $588.84	Professional	TC	$288.40	$371.54	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $173.78 / $912.01	Professional		$32.36	$173.78	$912.01
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	26	$891.25	$891.25	$891.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $660.69 / $707.95	Professional		$446.68	$660.69	$707.95
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $114.82	Professional	26	$72.44	$109.65	$114.82
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $549.54 / $588.84	Professional	TC	$380.19	$549.54	$588.84
Select Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $457.09 / $794.33	Professional		$302.00	$457.09	$794.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $77.62 / $128.82	Professional	26	$52.48	$77.62	$128.82
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $371.54 / $660.69	Professional	TC	$239.88	$371.54	$660.69
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $371.54 / $630.96	Professional		$74.13	$371.54	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $575.44	Professional		$275.42	$346.74	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $53.70 / $89.13	Professional	26	$42.66	$53.70	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $288.40 / $478.63	Professional	TC	$229.09	$288.40	$478.63