| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $1,044.00 | $1,409.70 | $1,822.10 |
Aetna
| Professional | QZ | $236.32 | $1,054.09 | $1,380.00 |
Ambetter
| Professional | AA | $520.34 | $1,225.00 | $2,145.00 |
Ambetter
| Professional | QZ | $207.30 | $1,265.00 | $1,690.00 |