| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $501.19 | $616.60 | $758.58 |
Aetna
| Professional | QK | $288.40 | $346.74 | $436.52 |
Aetna
| Professional | QX | $251.19 | $338.84 | $446.68 |
Aetna
| Professional | QY | $288.40 | $316.23 | $407.38 |
Aetna
| Professional | QZ | $537.03 | $645.65 | $794.33 |
Cigna
| Professional | AA | $389.05 | $489.78 | $537.03 |