| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $660.69 | $1,380.38 | $4,570.88 |
Aetna
| Professional | QK | $295.12 | $549.54 | $812.83 |
Aetna
| Professional | QX | $389.05 | $549.54 | $812.83 |
Aetna
| Professional | QZ | $436.52 | $436.52 | $436.52 |