| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $933.25 | $1,174.90 | $1,621.81 |
Aetna
| Professional | QZ | $831.76 | $1,148.15 | $1,412.54 |
Ambetter
| Professional | AA | $371.54 | $416.87 | $489.78 |
Ambetter
| Professional | QZ | $302.00 | $346.74 | $616.60 |