| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.97 | $181.97 | $181.97 | |
Aetna
| Professional | $125.89 | $154.88 | $223.87 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 | |
Select Health
| Professional | $125.89 | $125.89 | $125.89 | |
U of Utah Health Plan
| Professional | $173.78 | $194.98 | $213.80 |