| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $954.99 | $954.99 | $954.99 |
Aetna
| Professional | QZ | $812.83 | $954.99 | $1,148.15 |
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 |