| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $660.69 | $1,412.54 | $2,818.38 |
Aetna
| Professional | QX | $457.09 | $676.08 | $912.01 |
Aetna
| Professional | QY | $436.52 | $602.56 | $831.76 |
Aetna
| Professional | QZ | $1,096.48 | $2,041.74 | $2,041.74 |