| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $457.09 | $977.24 | $1,659.59 |
Aetna
| Professional | QZ | $309.03 | $457.09 | $1,288.25 |
Ambetter
| Professional | AA | $158.49 | $181.97 | $199.53 |
Ambetter
| Professional | QZ | $154.88 | $213.80 | $295.12 |