| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $732.69 | $854.81 | $1,364.06 |
Aetna
| Professional | QX | $199.07 | $199.07 | $249.89 |
Cigna
| Professional | AA | $465.43 | $465.43 | $528.90 |
United
| Professional | QX | $90.00 | $90.00 | $90.00 |