| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $354.81 | $575.44 | $1,230.27 |
Aetna
| Professional | QZ | $263.03 | $407.38 | $724.44 |
Ambetter
| Professional | AA | $117.49 | $218.78 | $616.60 |
Ambetter
| Professional | QZ | $117.49 | $165.96 | $354.81 |