| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $585.44 | $608.29 | $912.00 |
Aetna
| Professional | QZ | $573.23 | $573.23 | $848.37 |
Ambetter
| Professional | AA | $330.39 | $330.39 | $330.39 |
Ambetter
| Professional | QZ | $135.72 | $550.27 | $550.27 |
Cigna
| Professional | AA | $411.42 | $411.42 | $514.28 |