| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,257.19 | $3,360.00 | $3,780.00 |
Aetna
| Professional | QZ | $3,479.53 | $3,479.53 | $3,479.53 |
Cigna
| Professional | AA | $1,279.94 | $1,279.94 | $1,454.48 |
United
| Professional | QZ | $80.00 | $80.00 | $80.00 |