| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $771.90 | $1,540.00 | $2,240.00 |
Aetna
| Professional | QZ | $233.45 | $233.45 | $233.45 |
Ambetter
| Professional | AA | $801.44 | $1,082.16 | $2,164.32 |
Ambetter
| Professional | QZ | $213.29 | $845.00 | $996.00 |