| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $112.20 | $112.20 | |
Aetna
| Professional | $107.15 | $125.89 | $257.04 | |
Molina
| Professional | $30.20 | $44.67 | $194.98 | |
Select Health
| Professional | $173.78 | $177.83 | $177.83 | |
U of Utah Health Plan
| Professional | $165.96 | $186.21 | $204.17 |