| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,162.28 | $6,918.31 | $13,803.84 | |
Aetna
| Facility | 50 | $3,715.35 | $9,332.54 | $17,378.01 |
Regence BlueShield
| Facility | $10,471.29 | $12,302.69 | $28,183.83 | |
Regence BlueShield
| Facility | 50 | $15,488.17 | $18,197.01 | $41,686.94 |
U of Utah Health Plan
| Professional | $645.65 | $851.14 | $1,122.02 | |
United
| Facility | $2,884.03 | $5,128.61 | $13,803.84 |