| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QZ | $922.50 | $922.50 | $1,300.73 |
Ambetter
| Professional | AA | $356.22 | $569.48 | $1,520.00 |
Ambetter
| Professional | QZ | $551.65 | $551.65 | $551.65 |
United
| Professional | QZ | $80.00 | $80.00 | $80.00 |