| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $239.88 | $446.68 | $977.24 |
Aetna
| Professional | QZ | $371.54 | $457.09 | $616.60 |
Ambetter
| Professional | AA | $588.84 | $588.84 | $588.84 |
Ambetter
| Professional | QZ | $120.23 | $338.84 | $812.83 |
Cigna
| Professional | AA | $354.81 | $354.81 | $436.52 |