| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QZ | $533.50 | $1,218.24 | $1,273.32 |
Aetna
| Professional | AA | $374.20 | $589.84 | $1,540.00 |
Ambetter
| Professional | AA | $133.84 | $195.02 | $750.00 |
Cigna
| Professional | AA | $274.27 | $274.27 | $342.85 |