| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $109.73 | $109.73 | $109.73 |
Cigna
| Professional | AA | $411.42 | $485.10 | $514.28 |
Wellmark
| Professional | AA | $444.00 | $444.00 | $444.00 |
Wellmark
| Professional | QZ | $346.20 | $346.20 | $346.20 |