| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $697.76 | $789.60 | $872.20 |
Cigna
| Professional | AA | $274.27 | $323.39 | $342.85 |
Wellmark
| Professional | AA | $296.00 | $296.00 | $296.00 |
Wellmark
| Professional | QZ | $230.80 | $230.80 | $230.80 |