| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $335.50 | $478.98 | $756.60 |
Aetna
| Professional | QZ | $168.22 | $396.68 | $460.26 |
Ambetter
| Professional | AA | $151.09 | $272.11 | $720.00 |
Ambetter
| Professional | QZ | $116.22 | $325.42 | $605.00 |