| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $549.54 | $954.99 | $1,659.59 |
Aetna
| Professional | QZ | $147.91 | $602.56 | $1,096.48 |
Ambetter
| Professional | AA | $117.49 | $173.78 | $218.78 |
Ambetter
| Professional | QZ | $131.83 | $165.96 | $331.13 |