| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QZ | $673.40 | $673.40 | $673.40 |
Aetna
| Professional | AA | $842.80 | $980.00 | $1,076.14 |
Aetna
| Professional | QZ | $234.68 | $416.00 | $416.00 |
Cigna
| Professional | AA | $342.85 | $400.85 | $431.63 |