| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna
| Professional | QZ | $812.83 | $954.99 | $1,148.15 |
Ambetter
| Professional | QZ | $162.18 | $173.78 | $630.96 |
Cigna
| Professional | AA | $416.87 | $416.87 | $524.81 |