| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $204.58 | $737.30 | $1,024.52 |
Aetna
| Professional | QZ | $898.08 | $947.73 | $972.92 |
Ambetter
| Professional | QZ | $864.71 | $864.71 | $1,336.37 |
Cigna
| Professional | AA | $411.42 | $411.42 | $514.28 |