| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $336.00 | $585.44 | $980.00 |
Aetna
| Professional | QZ | $359.22 | $535.01 | $649.66 |
Ambetter
| Professional | AA | $162.52 | $587.37 | $720.00 |
Ambetter
| Professional | QZ | $115.86 | $260.02 | $603.00 |
Cigna
| Professional | AA | $274.27 | $274.27 | $342.85 |