| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $602.56 | $1,174.90 | $1,819.70 |
Aetna
| Professional | QZ | $588.84 | $812.83 | $1,174.90 |
Ambetter
| Professional | AA | $194.98 | $194.98 | $257.04 |
Ambetter
| Professional | QZ | $117.49 | $199.53 | $275.42 |