| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.88 | $12.88 | $12.88 | |
Regence BlueShield
| Facility | $933.25 | $1,096.48 | $2,511.89 | |
U of Utah Health Plan
| Professional | $1.38 | $1.58 | $41.69 | |
United
| Facility | $1,096.48 | $2,818.38 | $5,128.61 |