| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.11 | $33.11 | $33.11 | |
Aetna
| Professional | $33.11 | $33.11 | $64.57 | |
Regence BlueShield
| Facility | $61.66 | $72.44 | $162.18 | |
U of Utah Health Plan
| Professional | $38.02 | $38.02 | $38.02 |