| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QZ | $691.83 | $691.83 | $794.33 |
Aetna
| Professional | AA | $562.34 | $954.99 | $1,949.84 |
Aetna
| Professional | QZ | $436.52 | $691.83 | $1,023.29 |
Cigna
| Professional | AA | $416.87 | $416.87 | $524.81 |