| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $512.86 | $660.69 | $977.24 |
Aetna
| Professional | QZ | $141.25 | $489.78 | $707.95 |
Ambetter
| Professional | AA | $138.04 | $177.83 | $562.34 |
Ambetter
| Professional | QZ | $120.23 | $186.21 | $416.87 |