| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $641.95 | $1,346.36 | $1,658.66 |
Aetna
| Professional | QZ | $849.60 | $1,098.09 | $1,300.50 |
Ambetter
| Professional | AA | $344.25 | $435.38 | $2,015.00 |
Ambetter
| Professional | QZ | $320.95 | $320.95 | $361.08 |