| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $887.28 | $1,530.52 | $6,175.77 | |
Ambetter
| Professional | $1,362.32 | $1,362.32 | $1,362.32 | |
Qualchoice
| Professional | $1,566.67 | $1,566.67 | $1,566.67 | |
United
| Professional | $804.88 | $1,054.24 | $1,726.81 |