| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $645.65 | $1,071.52 | $1,548.82 |
Aetna
| Professional | QZ | $537.03 | $537.03 | $851.14 |
Ambetter
| Professional | AA | $177.83 | $354.81 | $741.31 |
Ambetter
| Professional | QZ | $162.18 | $218.78 | $354.81 |