| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $537.03 | $870.96 | $1,348.96 |
Aetna
| Professional | QZ | $338.84 | $645.65 | $912.01 |
Ambetter
| Professional | AA | $173.78 | $181.97 | $316.23 |
Ambetter
| Professional | QZ | $141.25 | $194.98 | $263.03 |