| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $338.84 | $338.84 | $436.52 |
Aetna
| Professional | QZ | $281.84 | $331.13 | $380.19 |
Moda Health
| Professional | AA | $338.84 | $338.84 | $436.52 |
Moda Health
| Professional | QZ | $281.84 | $331.13 | $380.19 |