| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $356.00 | $420.00 | $544.00 |
Aetna
| Professional | QZ | $810.00 | $810.00 | $884.80 |
Ambetter
| Professional | AA | $157.60 | $180.45 | $260.64 |
Ambetter
| Professional | QZ | $177.30 | $187.15 | $221.63 |