| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $588.84 | $912.01 | $912.01 |
Aetna
| Professional | QZ | $575.44 | $575.44 | $851.14 |
Cigna
| Professional | AA | $416.87 | $478.63 | $524.81 |
Wellmark
| Professional | AA | $446.68 | $446.68 | $446.68 |
Wellmark
| Professional | QZ | $346.74 | $346.74 | $346.74 |