| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $660.69 | $1,023.29 | $1,548.82 |
Aetna
| Professional | QZ | $173.78 | $741.31 | $1,174.90 |
Ambetter
| Professional | AA | $173.78 | $177.83 | $218.78 |
Ambetter
| Professional | QZ | $141.25 | $158.49 | $407.38 |