| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.10 | $63.10 | $63.10 | |
Aetna
| Professional | $10.00 | $26.92 | $63.10 | |
Regence BlueShield
| Facility | $56.23 | $66.07 | $147.91 | |
U of Utah Health Plan
| Professional | $36.31 | $36.31 | $36.31 |