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 $120.23 / $151.36 / $281.84	Professional		$120.23	$151.36	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $120.23	Professional	26	$39.81	$51.29	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $107.15 / $208.93	Professional	TC	$81.28	$107.15	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $190.55 / $288.40	Professional		$154.88	$190.55	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $93.33	Professional	26	$47.86	$63.10	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $204.17	Professional	TC	$102.33	$128.82	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $691.83	Professional		$32.36	$33.11	$691.83
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	26	$416.87	$416.87	$416.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $1,513.56	Professional		$204.17	$288.40	$1,513.56
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $89.13 / $120.23	Professional	26	$63.10	$89.13	$120.23
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $977.24	Professional	TC	$141.25	$190.55	$977.24
Select Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $208.93 / $281.84	Professional		$131.83	$208.93	$281.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $67.61 / $93.33	Professional	26	$42.66	$67.61	$93.33
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $141.25 / $186.21	Professional	TC	$89.13	$141.25	$186.21
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $138.04 / $245.47	Professional		$58.88	$138.04	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $251.19	Professional		$123.03	$162.18	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $87.10	Professional	26	$38.90	$51.29	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $109.65 / $173.78	Professional	TC	$81.28	$109.65	$173.78