| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $2,290.87 | $2,511.89 | $2,818.38 |
Aetna
| Professional | QZ | $371.54 | $371.54 | $416.87 |
Ambetter
| Professional | AA | $239.88 | $239.88 | $891.25 |
Ambetter
| Professional | QZ | $263.03 | $457.09 | $1,380.38 |