| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $426.58 | $831.76 | $1,230.27 |
Aetna
| Professional | QK | $302.00 | $426.58 | $660.69 |
Aetna
| Professional | QX | $288.40 | $398.11 | $630.96 |
Aetna
| Professional | QY | $309.03 | $407.38 | $645.65 |
Aetna
| Professional | QZ | $354.81 | $602.56 | $794.33 |