| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $398.11 | $537.03 | $812.83 |
Aetna
| Professional | QZ | $457.09 | $691.83 | $870.96 |
Cigna
| Professional | AA | $281.84 | $316.23 | $354.81 |
Wellmark
| Professional | AA | $295.12 | $295.12 | $295.12 |
Wellmark
| Professional | QZ | $229.09 | $229.09 | $229.09 |