| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.86 | $75.86 | $75.86 | |
Aetna
| Professional | $56.23 | $64.57 | $93.33 | |
Cigna
| Professional | $63.10 | $100.00 | $177.83 | |
Molina
| Professional | $30.20 | $102.33 | $186.21 | |
Regence BlueShield
| Professional | $72.44 | $95.50 | $128.82 | |
Select Health
| Professional | $63.10 | $85.11 | $120.23 | |
U of Utah Health Plan
| Professional | $81.28 | $107.15 | $144.54 | |
United
| Professional | $66.07 | $85.11 | $138.04 |