| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $446.68 | $457.09 | $2,884.03 |
Aetna
| Professional | QZ | $407.38 | $512.86 | $741.31 |
Moda Health
| Professional | AA | $446.68 | $457.09 | $2,884.03 |
Moda Health
| Professional | QZ | $407.38 | $524.81 | $812.83 |