| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,187.76 | $2,344.23 | $3,548.13 |
Aetna
| Professional | QZ | $371.54 | $416.87 | $2,951.21 |
Ambetter
| Professional | AA | $239.88 | $630.96 | $1,584.89 |
Ambetter
| Professional | QZ | $263.03 | $263.03 | $912.01 |