| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $154.88 | $794.33 | $977.24 |
Aetna
| Professional | QZ | $91.20 | $102.33 | $616.60 |
Ambetter
| Professional | AA | $338.84 | $416.87 | $436.52 |
Ambetter
| Professional | QZ | $134.90 | $229.09 | $389.05 |