| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,160.00 | $2,448.00 | $2,800.00 |
Aetna
| Professional | QZ | $970.66 | $970.66 | $970.66 |
Ambetter
| Professional | AA | $813.56 | $813.56 | $813.56 |
Cigna
| Professional | AA | $617.13 | $617.13 | $771.41 |