| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $432.00 | $721.12 | $1,216.69 |
Aetna
| Professional | QZ | $343.94 | $648.28 | $840.73 |
Ambetter
| Professional | QZ | $172.08 | $318.35 | $1,170.00 |
Cigna
| Professional | AA | $342.85 | $342.85 | $428.56 |