| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.61 | $67.61 | $67.61 | |
Aetna
| Professional | $67.61 | $67.61 | $79.43 | |
Cigna
| Professional | $74.13 | $74.13 | $74.13 | |
U of Utah Health Plan
| Professional | $660.69 | $741.31 | $741.31 | |
United
| Professional | $66.07 | $77.62 | $79.43 |