Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $22.91	Facility	26	$22.91	$22.91	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $131.83 / $288.40	Professional		$81.28	$131.83	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $31.62 / $141.25	Professional	26	$19.95	$31.62	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $81.28 / $169.82	Professional	TC	$58.88	$81.28	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $125.89 / $218.78	Professional		$45.71	$125.89	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $35.48 / $57.54	Professional	26	$13.18	$35.48	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $91.20 / $162.18	Professional	TC	$32.36	$91.20	$162.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $234.42	Professional		$141.25	$154.88	$234.42
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $41.69 / $57.54	Professional	26	$35.48	$41.69	$57.54
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $109.65 / $177.83	Professional	TC	$100.00	$109.65	$177.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $302.00	Professional		$131.83	$190.55	$302.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $81.28	Professional	26	$32.36	$50.12	$81.28
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $141.25 / $223.87	Professional	TC	$89.13	$141.25	$223.87
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $123.03 / $218.78	Professional		$44.67	$123.03	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $173.78	Professional		$54.95	$85.11	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $21.88 / $43.65	Professional	26	$15.49	$21.88	$43.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $63.10 / $134.90	Professional	TC	$39.81	$63.10	$134.90