| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $380.19 | $741.31 | $1,621.81 |
Aetna
| Professional | QZ | $204.17 | $407.38 | $1,047.13 |
Ambetter
| Professional | AA | $141.25 | $257.04 | $562.34 |
Ambetter
| Professional | QZ | $138.04 | $199.53 | $602.56 |