| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $556.16 | $958.49 | $1,960.00 |
Aetna
| Professional | QZ | $815.81 | $940.09 | $1,197.44 |
Ambetter
| Professional | AA | $552.57 | $552.57 | $552.57 |
Ambetter
| Professional | QZ | $390.05 | $1,179.15 | $1,493.59 |
Cigna
| Professional | AA | $411.42 | $411.42 | $514.28 |