| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,540.00 | $1,540.00 | $1,540.00 |
Cigna
| Professional | AA | $415.53 | $522.50 | $879.35 |
Health Partners
| Professional | AA | $308.58 | $501.30 | $1,230.59 |
United
| Professional | QZ | $75.00 | $75.00 | $75.00 |