| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $363.08 | $363.08 | $398.11 |
Aetna
| Professional | QZ | $371.54 | $446.68 | $537.03 |
Moda Health
| Professional | AA | $363.08 | $363.08 | $398.11 |
Moda Health
| Professional | QZ | $371.54 | $446.68 | $537.03 |