| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $682.50 | $1,060.50 | $1,121.09 |
Aetna
| Professional | QZ | $434.72 | $434.72 | $434.72 |
Ambetter
| Professional | AA | $147.63 | $175.52 | $175.52 |
Ambetter
| Professional | QZ | $306.00 | $306.00 | $306.00 |