| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $604.52 | $604.52 | $760.28 |
Aetna
| Professional | AA | $630.69 | $1,353.40 | $1,820.00 |
Aetna
| Professional | QZ | $436.39 | $513.24 | $590.40 |
Cigna
| Professional | AA | $411.42 | $481.02 | $517.96 |