| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $446.68 | $660.69 | $1,412.54 |
Aetna
| Professional | QZ | $309.03 | $398.11 | $630.96 |
Ambetter
| Professional | AA | $141.25 | $181.97 | $741.31 |
Ambetter
| Professional | QZ | $117.49 | $162.18 | $562.34 |