| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $588.84 | $870.96 | $1,698.24 |
Aetna
| Professional | QZ | $436.52 | $549.54 | $1,148.15 |
Ambetter
| Professional | AA | $181.97 | $199.53 | $912.01 |
Ambetter
| Professional | QZ | $154.88 | $245.47 | $776.25 |