| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $457.09 | $1,047.13 | $1,778.28 |
Aetna
| Professional | QZ | $288.40 | $707.95 | $1,174.90 |
Ambetter
| Professional | AA | $162.18 | $346.74 | $758.58 |
Ambetter
| Professional | QZ | $162.18 | $275.42 | $758.58 |