| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,820.00 | $1,820.00 | $1,820.00 |
Aetna
| Professional | QZ | $542.65 | $664.94 | $859.51 |
Ambetter
| Professional | AA | $191.20 | $191.20 | $191.20 |
Ambetter
| Professional | QZ | $152.96 | $628.88 | $864.71 |
Cigna
| Professional | AA | $411.42 | $411.42 | $514.28 |