| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $616.60 | $1,174.90 | $1,905.46 |
Aetna
| Professional | QZ | $234.42 | $851.14 | $1,479.11 |
Ambetter
| Professional | AA | $181.97 | $676.08 | $1,584.89 |
Ambetter
| Professional | QZ | $199.53 | $851.14 | $1,862.09 |