| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $302.00 | $1,096.48 | $1,621.81 |
Aetna
| Professional | QZ | $154.88 | $1,023.29 | $1,445.44 |
Cigna
| Professional | AA | $281.84 | $346.74 | $524.81 |
Health Partners
| Professional | AA | $269.15 | $323.59 | $851.14 |