| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $758.58 | $1,318.26 | $1,862.09 |
Aetna
| Professional | QZ | $234.42 | $912.01 | $1,479.11 |
Ambetter
| Professional | AA | $380.19 | $380.19 | $380.19 |
Ambetter
| Professional | QZ | $158.49 | $245.47 | $331.13 |