| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $700.00 | $1,400.00 | $2,100.00 |
Aetna
| Professional | QZ | $348.40 | $434.72 | $494.00 |
Ambetter
| Professional | AA | $233.45 | $233.45 | $233.45 |
Ambetter
| Professional | QZ | $159.12 | $179.01 | $357.00 |