| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.13 | $89.13 | $89.13 | |
Aetna
| Professional | $85.11 | $97.72 | $107.15 | |
Molina
| Professional | $30.20 | $44.67 | $173.78 | |
Select Health
| Professional | $151.36 | $158.49 | $158.49 | |
U of Utah Health Plan
| Professional | $131.83 | $147.91 | $162.18 |