| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $380.19 | $602.56 | $831.76 |
Aetna
| Professional | QZ | $478.63 | $691.83 | $891.25 |
Cigna
| Professional | AA | $354.81 | $398.11 | $436.52 |
Wellmark
| Professional | AA | $371.54 | $371.54 | $371.54 |
Wellmark
| Professional | QZ | $288.40 | $288.40 | $288.40 |