| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $234.42 | $954.99 | $1,778.28 |
Aetna
| Professional | QZ | $524.81 | $676.08 | $1,698.24 |
Ambetter
| Professional | AA | $190.55 | $512.86 | $1,174.90 |
Ambetter
| Professional | QZ | $147.91 | $446.68 | $1,548.82 |