| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $575.44 | $831.76 | $1,288.25 |
Aetna
| Professional | QZ | $371.54 | $691.83 | $1,047.13 |
Ambetter
| Professional | AA | $120.23 | $213.80 | $380.19 |
Ambetter
| Professional | QZ | $138.04 | $213.80 | $371.54 |