| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $645.65 | $1,023.29 | $1,778.28 |
Aetna
| Professional | QK | $316.23 | $489.78 | $724.44 |
Aetna
| Professional | QX | $281.84 | $446.68 | $676.08 |
Aetna
| Professional | QY | $309.03 | $436.52 | $676.08 |
Aetna
| Professional | QZ | $331.13 | $616.60 | $912.01 |