| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.13 | $89.13 | $89.13 | |
Aetna
| Professional | $77.62 | $93.33 | $977.24 | |
Cigna
| Professional | $85.11 | $104.71 | $165.96 | |
Molina
| Professional | $30.20 | $44.67 | $134.90 | |
Regence BlueShield
| Professional | $89.13 | $120.23 | $169.82 | |
Select Health
| Professional | $120.23 | $120.23 | $177.83 | |
U of Utah Health Plan
| Professional | $102.33 | $117.49 | $123.03 | |
United
| Professional | $69.18 | $89.13 | $134.90 |