| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,047.13 | $4,570.88 | $9,332.54 | |
Aetna
| Facility | 50 | $2,089.30 | $3,890.45 | $6,606.93 |
Regence BlueShield
| Facility | $9,549.93 | $11,220.18 | $26,302.68 | |
Regence BlueShield
| Facility | 50 | $14,454.40 | $16,982.44 | $38,904.51 |
U of Utah Health Plan
| Professional | $575.44 | $691.83 | $1,047.13 | |
United
| Facility | $2,137.96 | $5,128.61 | $8,317.64 |