| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $120.23 | $120.23 | |
Aetna
| Professional | $89.13 | $107.15 | $251.19 | |
Cigna
| Professional | $125.89 | $147.91 | $229.09 | |
Molina
| Professional | $32.36 | $33.11 | $213.80 | |
Regence BlueShield
| Professional | $109.65 | $138.04 | $194.98 | |
Select Health
| Professional | $107.15 | $173.78 | $204.17 | |
U of Utah Health Plan
| Professional | $128.82 | $158.49 | $213.80 | |
United
| Professional | $93.33 | $123.03 | $177.83 |