| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $549.54 | $1,122.02 | $1,819.70 |
Aetna
| Professional | QZ | $147.91 | $891.25 | $1,096.48 |
Ambetter
| Professional | AA | $162.18 | $181.97 | $512.86 |
Ambetter
| Professional | QZ | $123.03 | $158.49 | $213.80 |