| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QZ | $616.60 | $616.60 | $616.60 |
Aetna
| Professional | AA | $501.19 | $1,047.13 | $2,089.30 |
Ambetter
| Professional | AA | $213.80 | $213.80 | $213.80 |
Cigna
| Facility | QK | $30.90 | $30.90 | $30.90 |
Cigna
| Facility | QX | $30.90 | $30.90 | $30.90 |
Cigna
| Facility | QY | $30.90 | $30.90 | $30.90 |
Highmark BCBS
| Professional | AA | $234.42 | $512.86 | $758.58 |