| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,800.00 | $2,800.00 | $2,800.00 |
Aetna
| Professional | QZ | $453.26 | $453.26 | $453.26 |
Cigna
| Professional | AA | $623.29 | $783.76 | $1,319.02 |
Health Partners
| Professional | AA | $462.87 | $751.95 | $1,845.90 |