| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,137.96 | $2,137.96 | $2,454.71 |
Aetna
| Professional | QZ | $977.24 | $977.24 | $977.24 |
Cigna
| Professional | AA | $630.96 | $707.95 | $794.33 |
Wellmark
| Professional | AA | $660.69 | $660.69 | $660.69 |
Wellmark
| Professional | QZ | $524.81 | $524.81 | $524.81 |