| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,202.26 | $1,621.81 | $3,981.07 |
Aetna
| Professional | QZ | $1,659.59 | $2,344.23 | $3,548.13 |
Ambetter
| Professional | AA | $1,949.84 | $1,949.84 | $1,949.84 |
Ambetter
| Professional | QZ | $1,621.81 | $1,621.81 | $1,621.81 |