| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,290.87 | $2,290.87 | $2,511.89 |
Aetna
| Professional | QZ | $977.24 | $977.24 | $977.24 |
Ambetter
| Professional | AA | $933.25 | $933.25 | $933.25 |
Ambetter
| Professional | QZ | $416.87 | $416.87 | $416.87 |