| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $239.88 | $724.44 | $1,548.82 |
Aetna
| Professional | QZ | $204.17 | $602.56 | $912.01 |
Ambetter
| Professional | AA | $181.97 | $223.87 | $562.34 |
Ambetter
| Professional | QZ | $223.87 | $398.11 | $616.60 |