| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.50 | $95.50 | $95.50 | |
Aetna
| Professional | $91.20 | $107.15 | $138.04 | |
Molina
| Professional | $30.20 | $44.67 | $162.18 | |
Select Health
| Professional | $141.25 | $147.91 | $147.91 | |
U of Utah Health Plan
| Professional | $144.54 | $162.18 | $177.83 |