| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $338.84 | $588.84 | $1,174.90 |
Ambetter
| Professional | AA | $389.05 | $389.05 | $389.05 |
Ambetter
| Professional | QZ | $354.81 | $354.81 | $354.81 |
Cigna
| Professional | AA | $281.84 | $281.84 | $354.81 |