| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $125.89 | |
Aetna
| Professional | $125.89 | $125.89 | $151.36 | |
U of Utah Health Plan
| Professional | $89.13 | $107.15 | $109.65 | |
United
| Professional | $147.91 | $165.96 | $177.83 |