| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $478.63 | $794.33 | $1,412.54 |
Aetna
| Professional | QZ | $575.44 | $741.31 | $1,288.25 |
Ambetter
| Professional | AA | $177.83 | $323.59 | $776.25 |
Ambetter
| Professional | QZ | $141.25 | $186.21 | $407.38 |