| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,754.23 | $8,128.31 | $13,489.63 | |
Aetna
| Facility | 50 | $6,309.57 | $6,309.57 | $6,606.93 |
Regence BlueShield
| Facility | $14,791.08 | $17,378.01 | $37,153.52 | |
Regence BlueShield
| Facility | 50 | $21,877.62 | $26,302.68 | $56,234.13 |
U of Utah Health Plan
| Professional | $812.83 | $1,000.00 | $1,348.96 | |
United
| Facility | $3,019.95 | $5,128.61 | $23,442.29 |