| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $812.83 | $1,230.27 | $2,818.38 |
Aetna
| Professional | QX | $338.84 | $588.84 | $954.99 |
Aetna
| Professional | QY | $288.40 | $549.54 | $1,071.52 |
Aetna
| Professional | QZ | $371.54 | $602.56 | $1,778.28 |