| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $446.68 | $741.31 | $1,318.26 |
Aetna
| Professional | QZ | $588.84 | $794.33 | $870.96 |
Ambetter
| Professional | QZ | $141.25 | $141.25 | $141.25 |
Cigna
| Professional | AA | $354.81 | $354.81 | $436.52 |