| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $436.52 | $676.08 | $1,096.48 |
Aetna
| Professional | QZ | $489.78 | $660.69 | $891.25 |
Ambetter
| Professional | AA | $162.18 | $229.09 | $933.25 |
Ambetter
| Professional | QZ | $162.18 | $239.88 | $707.95 |
Cigna
| Professional | AA | $354.81 | $354.81 | $436.52 |