| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $524.81 | $933.25 | $2,089.30 |
Aetna
| Professional | QZ | $741.31 | $954.99 | $1,905.46 |
Ambetter
| Professional | QZ | $199.53 | $302.00 | $1,047.13 |
Cigna
| Professional | AA | $489.78 | $489.78 | $616.60 |