| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $933.25 | $1,122.02 | $2,238.72 |
Aetna
| Professional | QZ | $691.83 | $691.83 | $1,479.11 |
Ambetter
| Professional | AA | $223.87 | $223.87 | $223.87 |
Ambetter
| Professional | QZ | $199.53 | $199.53 | $199.53 |