| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $575.44 | $1,047.13 | $1,548.82 |
Aetna
| Professional | QK | $288.40 | $380.19 | $676.08 |
Aetna
| Professional | QX | $295.12 | $398.11 | $707.95 |
Aetna
| Professional | QY | $302.00 | $398.11 | $741.31 |
Aetna
| Professional | QZ | $537.03 | $630.96 | $812.83 |