| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $676.08 | $1,230.27 | $1,659.59 |
Aetna
| Professional | QZ | $181.97 | $691.83 | $891.25 |
Ambetter
| Professional | AA | $169.82 | $1,071.52 | $1,819.70 |
Ambetter
| Professional | QZ | $162.18 | $954.99 | $1,621.81 |