Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	26	$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $331.13	Professional		$109.65	$151.36	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $57.54 / $125.89	Professional	TC	$38.90	$57.54	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $208.93 / $269.15	Professional		$131.83	$208.93	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $70.79 / $112.20	Professional	TC	$46.77	$70.79	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $245.47	Professional		$32.36	$60.26	$245.47
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $457.09 / $457.09	Facility	26	$457.09	$457.09	$457.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $302.00	Professional		$213.80	$251.19	$302.00
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $89.13 / $97.72	Professional	TC	$79.43	$89.13	$97.72
Select Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $363.08	Professional		$134.90	$229.09	$363.08
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $81.28 / $117.49	Professional	TC	$48.98	$81.28	$117.49
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $141.25 / $275.42	Professional		$69.18	$141.25	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $257.04	Professional		$128.82	$151.36	$257.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $95.50	Professional	TC	$44.67	$52.48	$95.50