| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $765.90 | $1,099.04 | $1,540.00 |
Aetna
| Professional | QZ | $396.80 | $1,010.10 | $1,647.54 |
Cigna
| Professional | AA | $581.79 | $581.79 | $661.13 |
United
| Professional | AA | $88.00 | $88.00 | $88.00 |