| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $436.52 | $741.31 | $1,698.24 |
Aetna
| Professional | QZ | $630.96 | $831.76 | $912.01 |
Ambetter
| Professional | AA | $2,089.30 | $2,089.30 | $2,089.30 |
Ambetter
| Professional | QZ | $158.49 | $269.15 | $1,380.38 |
Cigna
| Professional | AA | $354.81 | $354.81 | $436.52 |