| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $741.31 | $1,412.54 | $2,570.40 |
Aetna
| Professional | QX | $371.54 | $575.44 | $912.01 |
Aetna
| Professional | QY | $380.19 | $549.54 | $831.76 |
Aetna
| Professional | QZ | $602.56 | $660.69 | $1,318.26 |