| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $583.79 | $1,540.00 | $2,545.60 |
Aetna
| Professional | QZ | $620.60 | $1,492.50 | $2,321.30 |
Ambetter
| Professional | AA | $220.99 | $585.00 | $1,950.00 |
Ambetter
| Professional | QZ | $212.99 | $212.99 | $212.99 |
Highmark BCBS
| Professional | AA | $356.00 | $858.60 | $1,469.93 |
Highmark BCBS
| Professional | QZ | $274.73 | $671.60 | $952.46 |