| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $478.63 | $478.63 | $630.96 |
Aetna
| Professional | QZ | $954.99 | $954.99 | $954.99 |
Ambetter
| Professional | QZ | $218.78 | $218.78 | $1,096.48 |
Cigna
| Professional | AA | $416.87 | $416.87 | $524.81 |