| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $630.69 | $630.69 | $755.30 |
Aetna
| Professional | QZ | $306.55 | $306.55 | $306.55 |
BCBS
| Professional | QZ | $184.90 | $406.06 | $480.25 |
Health Alliance Plan
| Professional | AA | $630.69 | $630.69 | $755.30 |
Health Alliance Plan
| Professional | QZ | $306.55 | $306.55 | $306.55 |