| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,019.95 | $5,370.32 | $7,943.28 | |
Aetna
| Facility | 50 | $3,890.45 | $4,897.79 | $6,606.93 |
Regence BlueShield
| Facility | $5,128.61 | $6,025.60 | $13,489.63 | |
Regence BlueShield
| Facility | 50 | $7,585.78 | $8,912.51 | $20,417.38 |
U of Utah Health Plan
| Professional | $416.87 | $512.86 | $724.44 | |
United
| Facility | $2,137.96 | $5,128.61 | $8,317.64 |