| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $582.40 | $742.50 | $1,680.00 |
Aetna
| Professional | QZ | $473.08 | $1,402.50 | $1,492.50 |
Ambetter
| Professional | AA | $178.11 | $277.06 | $464.88 |
Ambetter
| Professional | QZ | $158.32 | $266.20 | $1,196.00 |