| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $398.11 | $851.14 | $1,621.81 |
Aetna
| Professional | QZ | $363.08 | $575.44 | $831.76 |
Ambetter
| Professional | AA | $141.25 | $177.83 | $316.23 |
Ambetter
| Professional | QZ | $120.23 | $144.54 | $223.87 |