| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $616.60 | $1,288.25 | $2,041.74 |
Aetna
| Professional | QZ | $234.42 | $602.56 | $1,230.27 |
Ambetter
| Professional | AA | $169.82 | $245.47 | $645.65 |
Ambetter
| Professional | QZ | $117.49 | $199.53 | $302.00 |