| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $676.08 | $724.44 | $891.25 |
Aetna
| Professional | QZ | $630.96 | $630.96 | $676.08 |
Cigna
| Facility | QK | $30.90 | $30.90 | $30.90 |
Cigna
| Facility | QX | $30.90 | $30.90 | $30.90 |
Cigna
| Facility | QY | $30.90 | $30.90 | $30.90 |
Highmark BCBS
| Professional | QZ | $524.81 | $537.03 | $562.34 |