| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $268.51 | $531.03 | $1,387.28 |
Aetna
| Professional | QZ | $168.22 | $434.72 | $1,343.25 |
Ambetter
| Professional | AA | $118.74 | $158.32 | $272.11 |
Ambetter
| Professional | QZ | $126.66 | $222.64 | $920.00 |