| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $128.82 | $128.82 | |
Aetna
| Professional | $123.03 | $190.55 | $223.87 | |
Molina
| Professional | $30.20 | $44.67 | $154.88 | |
Select Health
| Professional | $134.90 | $138.04 | $138.04 | |
U of Utah Health Plan
| Professional | $275.42 | $309.03 | $338.84 |