| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $639.60 | $980.00 | $1,820.00 |
Aetna
| Professional | QZ | $825.28 | $825.28 | $879.69 |
Ambetter
| Professional | AA | $245.00 | $375.55 | $991.98 |
Ambetter
| Professional | QZ | $155.12 | $190.18 | $375.55 |