| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $457.09 | $1,174.90 | $2,290.87 |
Aetna
| Professional | QZ | $173.78 | $812.83 | $1,288.25 |
Ambetter
| Professional | AA | $169.82 | $218.78 | $234.42 |
Ambetter
| Professional | QZ | $194.98 | $223.87 | $302.00 |