| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,000.50 | $1,092.50 | $1,092.50 |
Aetna
| Professional | QZ | $234.68 | $234.68 | $234.68 |
Ambetter
| Professional | AA | $212.70 | $1,300.00 | $1,950.00 |
Ambetter
| Professional | QZ | $228.03 | $1,170.00 | $1,560.00 |