| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $537.03 | $794.33 | $1,318.26 |
Aetna
| Professional | QZ | $354.81 | $575.44 | $912.01 |
Ambetter
| Professional | AA | $165.96 | $181.97 | $288.40 |
Ambetter
| Professional | QZ | $169.82 | $199.53 | $295.12 |