| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $660.69 | $977.24 | $1,698.24 |
Aetna
| Professional | QZ | $467.74 | $776.25 | $1,230.27 |
Ambetter
| Professional | AA | $169.82 | $245.47 | $302.00 |
Ambetter
| Professional | QZ | $194.98 | $234.42 | $302.00 |