| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $623.70 | $1,185.70 | $1,386.10 |
Aetna
| Professional | QZ | $1,221.20 | $1,410.40 | $1,599.60 |
Ambetter
| Professional | AA | $510.00 | $510.00 | $510.00 |
Highmark BCBS
| Professional | AA | $391.50 | $391.50 | $391.50 |