| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,202.26 | $3,162.28 | $4,570.88 | |
Aetna
| Facility | 50 | $7,079.46 | $7,079.46 | $7,079.46 |
U of Utah Health Plan
| Professional | $218.78 | $1,174.90 | $1,737.80 | |
United
| Facility | $1,071.52 | $4,466.84 | $5,128.61 |