| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,584.89 | $1,584.89 | $1,698.24 |
Aetna
| Professional | QZ | $446.68 | $741.31 | $1,621.81 |
Moda Health
| Professional | AA | $831.76 | $1,584.89 | $1,698.24 |
Moda Health
| Professional | QZ | $208.93 | $741.31 | $2,187.76 |