| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $436.52 | $588.84 | $1,412.54 |
Aetna
| Professional | QZ | $309.03 | $537.03 | $933.25 |
Ambetter
| Professional | AA | $158.49 | $181.97 | $512.86 |
Ambetter
| Professional | QZ | $141.25 | $199.53 | $457.09 |