| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $147.91 | |
Aetna
| Professional | $123.03 | $147.91 | $269.15 | |
Cigna
| Professional | $165.96 | $165.96 | $165.96 | |
Select Health
| Professional | $169.82 | $169.82 | $169.82 | |
U of Utah Health Plan
| Professional | $134.90 | $151.36 | $151.36 | |
United
| Professional | $147.91 | $173.78 | $177.83 |