| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $466.69 | $968.00 | $1,960.00 |
Aetna
| Professional | QZ | $549.79 | $645.82 | $649.57 |
Ambetter
| Professional | AA | $154.96 | $420.54 | $1,012.00 |
Ambetter
| Professional | QZ | $212.96 | $973.80 | $1,196.00 |